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Zygomycetes in human disease.

J A Ribes1, C L Vanover-Sams, D J Baker

  • 1Departments of Pathology and Laboratory Medicine and of Clinical Laboratory Sciences, University of Kentucky, Lexington, KY 40536-0084, USA. jaribes@pop.uky.edu

Clinical Microbiology Reviews
|February 7, 2001
PubMed
Summary

Zygomycosis, a rare fungal infection, is primarily caused by Mucorales in immunocompromised individuals, often presenting as rhinocerebral or pulmonary disease. Early diagnosis and combined therapy are crucial for effective treatment of this angioinvasive infection.

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Area of Science:

  • Mycology
  • Clinical Microbiology
  • Infectious Diseases

Background:

  • Zygomycetes, including Mucorales and Entomophthorales, are uncommon clinical isolates, causing zygomycosis.
  • Mucorales, particularly Rhizopus spp., are the main cause of human zygomycosis, often opportunistic in immunocompromised hosts.
  • Entomophthorales are true pathogens, primarily affecting immunocompetent individuals in tropical regions.

Purpose of the Study:

  • To review the clinical significance of Zygomycetes.
  • To differentiate between Mucorales and Entomophthorales infections.
  • To outline host risk factors, disease manifestations, and treatment strategies for zygomycosis.

Main Methods:

  • Literature review of Zygomycetes, focusing on clinical disease.

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  • Analysis of transmission routes, host factors, and clinical presentations.
  • Discussion of therapeutic approaches, including antifungals and surgery.

    • Main Results:

    • Mucorales infections commonly occur in immunocompromised hosts (e.g., diabetics, neutropenic patients) via inhalation or percutaneous routes.
    • Disease manifestations include rhinocerebral, pulmonary, cutaneous, and gastrointestinal forms, often angioinvasive with high mortality if untreated.
    • Entomophthorales infections typically present as sinusitis or subcutaneous mycosis in immunocompetent hosts, rarely disseminating.

    Conclusions:

    • Zygomycosis requires early diagnosis and aggressive management, combining antifungal therapy, surgical debridement, and addressing underlying risk factors.
    • While Mucorales are opportunistic angioinvasive pathogens, Entomophthorales are true pathogens, though emerging opportunistic roles are noted.
    • Understanding the distinct characteristics of Mucorales and Entomophthorales is vital for appropriate patient management and treatment of zygomycosis.