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Mucormycosis of the head and neck

Michael Dan1

  • 1E. Wolfson Hospital, Holon, 58100, Israel, midan@post.tau.ac.il.

Current Infectious Disease Reports
|March 3, 2011
PubMed

Insights

Head and neck mucormycosis, a serious fungal infection, often affects diabetic patients and transplant recipients. Early diagnosis and aggressive treatment, including surgery and amphotericin B, are crucial for improving outcomes in this high-mortality condition.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Head and neck mucormycosis, caused by Mucorales fungi, represents up to 50% of all mucormycosis cases.
  • Rhinocerebral mucormycosis predominantly affects diabetic patients (approx. 70%) and is also observed in transplant recipients, those with neutropenia, or on deferoxamine therapy.
  • Emerging risk factors include hematopoietic stem cell transplantation and breakthrough infections in patients receiving voriconazole.

Purpose of the Study:

  • To review the epidemiology, risk factors, and current management strategies for head and neck mucormycosis.
  • To emphasize the critical need for early diagnosis and prompt intervention to improve patient survival rates.
  • To discuss the role of surgical debridement and antifungal therapies in treating this invasive fungal infection.

Main Methods:

  • Literature review of rhinocerebral mucormycosis cases and treatment outcomes.
  • Analysis of patient populations at risk, including immunocompromised individuals and those with specific medical conditions.
  • Evaluation of current therapeutic guidelines and emerging treatment options.

Main Results:

  • Rhinocerebral mucormycosis has a high mortality rate, ranging from 30% to 70%, despite aggressive treatment.
  • Early treatment initiation is strongly associated with improved patient outcomes.
  • Surgical excision of necrotic tissue is a cornerstone of effective management.

Conclusions:

  • Head and neck mucormycosis requires a high index of suspicion for prompt diagnosis, often necessitating biopsy of suspicious lesions.
  • Lipid formulations of amphotericin B are the current standard of care for mucormycosis treatment.
  • Posaconazole may be considered for salvage therapy, but its role as primary treatment is not yet established.

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