What Is New in Pulmonary Mucormycosis?

Area of Science:

• Mycology
• Infectious Diseases
• Pulmonology

Background:

• Mucormycosis is a rare, life-threatening fungal infection caused by Mucorales molds.
• Pulmonary mucormycosis (PM) is the third most common site of infection, with increasing incidence.
• Risk factors differ between rhino-orbito-cerebral and pulmonary forms, potentially due to distinct receptor interactions.

Purpose of the Study:

• To review the epidemiology, risk factors, diagnosis, and treatment of pulmonary mucormycosis.
• To highlight diagnostic advancements and current therapeutic guidelines.
• To underscore the persistent high mortality and the need for further research.

Main Methods:

• Review of current literature on pulmonary mucormycosis.
• Analysis of diagnostic modalities including CT scans, cultures, PCR, and histology.
• Evaluation of treatment strategies, including first-line and step-down therapies, and secondary prophylaxis.

Main Results:

• Pulmonary mucormycosis diagnosis relies on imaging (e.g., reversed halo sign) and laboratory tests, with serum PCR showing promise.
• Liposomal amphotericin B is the primary treatment, often combined with surgery and underlying condition management.
• Despite advancements, PM mortality exceeds 50%.

Conclusions:

• Effective management of PM requires prompt diagnosis and treatment with antifungal agents and source control.
• Further research is crucial for developing combination therapies and novel treatments to improve outcomes.
• Secondary prophylaxis is considered for patients at risk of relapse.