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Zygomycosis: an emerging fungal infection with new options for management

Carol A Kauffman1, Anurag N Malani

  • 1Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA. ckauff@umich.edu

Current Infectious Disease Reports
|November 15, 2007
PubMed

Insights

Zygomycosis, a serious fungal infection, primarily affects immunocompromised individuals and those with diabetes. Emerging risk factors include organ transplantation and hematologic malignancy, often linked to voriconazole use.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Immunocompromised Hosts

Background:

  • Zygomycosis is a severe fungal infection predominantly seen in patients with diabetes mellitus and those who are immunocompromised.
  • While diabetes is a primary risk factor, there's a notable increase in zygomycosis cases among transplant recipients and patients with hematologic malignancy.
  • Voriconazole use, particularly for prophylaxis, is increasingly associated with zygomycosis development in severely immunocompromised patient groups.

Purpose of the Study:

  • To review the epidemiology, clinical manifestations, and treatment strategies for zygomycosis.
  • To highlight the evolving risk factors and specific presentations in different patient populations.
  • To discuss current and emerging therapeutic options for this challenging infection.

Main Methods:

  • Literature review of studies on zygomycosis, focusing on risk factors, clinical patterns, and treatment outcomes.
  • Analysis of epidemiological trends and patient demographics.
  • Evaluation of antifungal therapies, including established and investigational agents.

Main Results:

  • Diabetes mellitus remains the most common risk factor, with rhino-orbital-cerebral zygomycosis being the typical presentation.
  • Transplant recipients and patients with hematologic malignancy face a higher risk, often presenting with pulmonary zygomycosis.
  • Voriconazole treatment or prophylaxis is linked to zygomycosis in severely immunocompromised individuals within these newer risk groups.

Conclusions:

  • Zygomycosis necessitates a comprehensive treatment approach, including addressing predisposing factors, surgical intervention, and antifungal therapy.
  • Lipid formulations of amphotericin B are the preferred first-line treatment.
  • Posaconazole shows promise in salvage therapy but requires an available intravenous formulation for broader first-line consideration.

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