Diagnosis of Mucormycosis Using Frozen Section, Histopathology, Culture, and Reverse Transcriptase Polymerase Chain...

Area of Science:

• Medical Mycology
• Infectious Diseases
• Molecular Diagnostics

Background:

• Mucormycosis is a severe fungal infection, often fatal, particularly affecting immunocompromised individuals and those with uncontrolled diabetes.
• The third wave of SARS-CoV-2 saw a significant rise in mucormycosis cases, exacerbated by increased steroid use during COVID-19 treatment.
• Timely diagnosis and management are critical for improving patient outcomes in mucormycosis.

Purpose of the Study:

• To evaluate the utility of a reverse transcriptase polymerase chain reaction (RT-PCR) method for detecting Mucor in patient plasma samples.
• To compare the diagnostic performance of RT-PCR with conventional methods like microbiological culture and histopathology for mucormycosis.

Main Methods:

• Nucleic acid was extracted from 69 tissue sections of histopathologically confirmed mucormycosis cases.
• Extracted nucleic acids were subjected to RT-PCR using the MucorGenius kit.
• Conventional microbiological culture was performed on 57 tissue samples for comparison.

Main Results:

• RT-PCR detected Mucor in 49% of cases, consistent with the positive rate of microbiological culture.
• The RT-PCR method demonstrated 80% sensitivity and 76% specificity when compared to culture.
• While this study used tissue samples, it highlights the potential of plasma-based RT-PCR for early detection.

Conclusions:

• RT-PCR offers a rapid and reliable diagnostic approach for mucormycosis compared to traditional methods.
• Detecting Mucor in blood or plasma via RT-PCR is identified as a preferred method for early diagnosis.
• Further research validating RT-PCR on plasma samples is recommended for clinical application in managing mucormycosis.