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Cold Spring Harbor Perspectives in... Nov 2014In recent years, we have seen an increase in the number of immunocompromised cohorts as a result of infections and/or medical conditions, which has resulted in an... (Review)
Review
In recent years, we have seen an increase in the number of immunocompromised cohorts as a result of infections and/or medical conditions, which has resulted in an increased incidence of fungal infections. Although rare, the incidence of infections caused by fungi belonging to basal fungal lineages is also continuously increasing. Basal fungal lineages diverged at an early point during the evolution of the fungal lineage, in which, in a simplified four-phylum fungal kingdom, Zygomycota and Chytridiomycota belong to the basal fungi, distinguishing them from Ascomycota and Basidiomycota. Currently there are no known human infections caused by fungi in Chytridiomycota; only Zygomycotan fungi are known to infect humans. Hence, infections caused by zygomycetes have been called zygomycosis, and the term "zygomycosis" is often used as a synonym for "mucormycosis." In the four-phylum fungal kingdom system, Zygomycota is classified mainly based on morphology, including the ability to form coenocytic (aseptated) hyphae and zygospores (sexual spores). In the Zygomycota, there are 10 known orders, two of which, the Mucorales and Entomophthorales, contain species that can infect humans, and the infection has historically been known as zygomycosis. However, recent multilocus sequence typing analyses (the fungal tree of life [AFTOL] project) revealed that the Zygomycota forms not a monophyletic clade but instead a polyphyletic clade, whereas Ascomycota and Basidiomycota are monophyletic. Thus, the term "zygomycosis" needed to be further specified, resulting in the terms "mucormycosis" and "entomophthoramycosis." This review covers these two different types of fungal infections.
Topics: Amphotericin B; Animals; Conidiobolus; Entomophthorales; Humans; Immunocompromised Host; Mice; Mucorales; Mucormycosis; Potassium Iodide; Randomized Controlled Trials as Topic; Zygomycosis
PubMed: 25377138
DOI: 10.1101/cshperspect.a019562 -
Clinical Microbiology and Infection :... Aug 2016The term 'entomophthoramycosis' classically refers to infections caused by members of the order Entomophthorales. A new subphylum, Entomophthoramycota, has been created... (Review)
Review
The term 'entomophthoramycosis' classically refers to infections caused by members of the order Entomophthorales. A new subphylum, Entomophthoramycota, has been created to include Basidiobolomycetes, Neozygitomycetes and Entomophthoramycetes. Basidiobolomycetes encompass Basidiobolus spp., while the Entomophthoramycetes include Conidiobolus spp. Conidiobolus spp. characteristically cause rhinofacial entomophthoramycosis in apparently immunocompetent hosts. Conidiobolus spp. may also cause disseminated infection in immunocompromised patients. Basidiobolus spp. more typically cause subcutaneous entomophthoramycosis of the limbs, buttocks, back and thorax in immunocompetent patients. While once considered to be rare, there is an increasing number of reported cases of gastrointestinal infection caused by Basidiobolus spp. worldwide in countries such as United States, Thailand, Australia, Iran, Egypt and Saudi Arabia. These cases have clinical presentations similar to those of inflammatory bowel diseases, particularly Crohn's disease. Retroperitoneal, pulmonary, nasal and disseminated basidiobolomycosis have also been reported. Histology of entomophthoramycosis may reveal the Splendore-Hoeppli phenomenon. Culture of infected tissue remains the definitive method of laboratory diagnosis. However, molecular methods with specific DNA probes and panfungal primers, as well as real time PCR, are increasingly used to detect and identify these organisms in tissue. Treatment largely consists of therapy with antifungal triazoles. Surgery plays a selective role in the management of entomophthoramycosis, depending upon location, organism and extent of the infection.
Topics: Animals; Combined Modality Therapy; Environmental Microbiology; Fungi; Host-Pathogen Interactions; Humans; Neglected Diseases; Phenotype; Treatment Outcome; Tropical Medicine; Zygomycosis
PubMed: 27109491
DOI: 10.1016/j.cmi.2016.04.005 -
Indian Journal of Medical Microbiology 2023
Topics: Animals; Female; Cattle; Mucormycosis; COVID-19
PubMed: 37356841
DOI: 10.1016/j.ijmmb.2023.100382 -
Clinical Microbiology and Infection :... Jun 2014Mucormycosis is an emerging fungal infection worldwide, with devastating disease symptoms and diverse clinical manifestations. The most important underlying risk factors... (Review)
Review
Mucormycosis is an emerging fungal infection worldwide, with devastating disease symptoms and diverse clinical manifestations. The most important underlying risk factors are immunosuppression, poorly controlled diabetes, iron overload and major trauma. The aetiological agents involved in the disease have been re-classified due to changes in taxonomy and nomenclature, which also led to appropriately naming the disease 'mucormycosis'. This article shortly explains the new nomenclature, clinical manifestations and risk factors and focuses on putative virulence traits associated with mucormycosis, mainly in the group of diabetic ketoacidotic patients.
Topics: Humans; Mucorales; Mucormycosis; Risk Factors; Virulence Factors
PubMed: 24476149
DOI: 10.1111/1469-0691.12566 -
Frontiers in Cellular and Infection... 2022The second wave of coronavirus disease 2019 (COVID-19) caused severe infections with high mortality. An increase in the cases of COVID-19-associated mucormycosis (CAM)... (Review)
Review
The second wave of coronavirus disease 2019 (COVID-19) caused severe infections with high mortality. An increase in the cases of COVID-19-associated mucormycosis (CAM) was reported predominantly in India. Commonly present in immunocompromised individuals, mucormycosis is often a life-threatening condition. Confounding factors and molecular mechanisms associated with CAM are still not well understood, and there is a need for careful research in this direction. In this review, a brief account of the diagnosis, management, and advancement in drug discovery for mucormycosis has been provided. Here, we summarize major factors that dictate the occurrence of mucormycosis in COVID-19 patients through the analysis of published literature and case reports. Major predisposing factors to mucormycosis appear to be uncontrolled diabetes, steroid therapy, and certain cancers. At the molecular level, increased levels of iron in COVID-19 might contribute to mucormycosis. We have also discussed the potential role and regulation of iron metabolism in COVID-19 patients in establishing fungal growth. Other factors including diabetes prevalence and fungal spore burden in India as contributing factors have also been discussed.
Topics: COVID-19; Diabetes Mellitus; Humans; Immunocompromised Host; India; Mucormycosis
PubMed: 35923801
DOI: 10.3389/fcimb.2022.937481 -
Journal of Infection and Public Health Apr 2022The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is yet to be controlled worldwide, especially in India. The second wave of... (Review)
Review
The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is yet to be controlled worldwide, especially in India. The second wave of coronavirus disease 2019 (COVID-19) led to panic and confusion in India, owing to the overwhelming number of the population that fell prey to this highly infectious virus of recent times. In the second wave of COVID-19, the patients had to fight both the virus and opportunistic infections triggered by fungi and bacteria. Repeated use of steroids, antibiotics, and oxygen masks during the management of severely and critically ill COVID-19 patients nurtured opportunistic infections such as mucormycosis. Despite mucormycosis being a decades-old disease, it has gained notice of its widespread occurrence in COVID-19 patients throughout India. Instances of mucormycosis are usually unearthed in immunocompromised individuals and are caused by the inhalation of filamentous fungi, either from the natural environment or through supportive care units. In the recent outbreak during the second wave of COVID-19 in India, it has been seen to cause secondary infection as it grows along with the treatment of COVID-19. Furthermore, COVID-19 patients with comorbidities such as diabetes were more likely to have the mucormycosis co-infection because of their challenged immune systems' inability to fight it. Despite the hype, mucormycosis still remains neglected and least studied, which is predominantly due to all focus on diagnostics, vaccine, and therapeutic research. In this review, we emphasize mainly on the association of mucormycosis in COVID-19 patients. We also present the molecular mechanism of mucormycosis for a better understanding of the fungal infections in patients who have recently been infected with SARS-CoV-2. Better understanding of fungal pathogens, immediate diagnosis, and management of the infections are crucial in COVID-19 patients, as high mortalities have been recorded in co-infected patients despite recovery from COVID-19.
Topics: COVID-19; Coinfection; Humans; Mucormycosis; Opportunistic Infections; Pandemics; SARS-CoV-2
PubMed: 35216920
DOI: 10.1016/j.jiph.2022.02.007 -
Medecine Et Sante Tropicales 2012This general review of the biomedical literature indexed on Medline (PubMed) and Pascal (INIST) over the past 40 years (1970-2010), supplemented by some unindexed... (Review)
Review
This general review of the biomedical literature indexed on Medline (PubMed) and Pascal (INIST) over the past 40 years (1970-2010), supplemented by some unindexed studies, found 89 articles published about basidiobolomycosis. These case reports (n = 67) and series (n = 22) described 172 cases of basidiobolomycosis (84 in Asia, 47 in tropical Africa, 25 in North America, 12 in South America, two in Europe and two in Australia). Patients younger than 15 tears accounted for 70%, and the sex-ratio (M/F) was 2.1. Clinically, basidiobolomycosis results in firm subcutaneous plaques, sharply circumscribed, generally cold and painless, becoming hot and painful during flares. It can cause invasive disease of the gastrointestinal tract or lungs and can even be disseminated throughout the body. The main treatments are potassium iodide, trimethoprim-sulfamethoxazole, and the azole derivatives. The latter are very effective and well tolerated, unlike the former, which present a risk of recurrence or severe side effects.
Topics: Entomophthorales; Humans; Zygomycosis
PubMed: 22890063
DOI: 10.1684/mst.2012.0047 -
Clinical Microbiology and Infection :... Oct 2009Zygomycoses are severe angio-invasive fungal infections that develop in immunocompromised and diabetic patients. Any episode of sinusitis not responding to short-term... (Review)
Review
Zygomycoses are severe angio-invasive fungal infections that develop in immunocompromised and diabetic patients. Any episode of sinusitis not responding to short-term antibacterial therapy should evoke the diagnosis of zygomycosis in the latter population, especially in cases of a surrounding necrotic area. Appropriate diagnosis is obtained after careful direct examination of the sample and culture. Current therapy underscores the need to control glycaemia and acidosis in addition to the need for urgent administration of high-dose liposomal amphotericin B in combination with extensive surgery.
Topics: Amphotericin B; Antifungal Agents; Diabetes Complications; Humans; Sinusitis; Zygomycosis
PubMed: 19754752
DOI: 10.1111/j.1469-0691.2009.02975.x -
Journal of Veterinary Diagnostic... Nov 2020We review herein infections by spp., spp., and spp. in sheep and goats. spp. are common causes of rhinitis in sheep and are less frequent in goats, in which spp.... (Review)
Review
We review herein infections by spp., spp., and spp. in sheep and goats. spp. are common causes of rhinitis in sheep and are less frequent in goats, in which spp. also cause skin lesions. spp. cause rhinitis, meningitis, encephalitis, and pneumonia in goats, and are rarely observed in sheep. spp. may cause rhinitis in goats, and pneumonia and mastitis in sheep and goats. Gross and microscopic lesions caused by these 3 fungal infections may be similar to each other. The diagnosis of these diseases must be based on gross and microscopic lesions, coupled with detection of the agent by immunohistochemical, molecular, and/or culture-based methods.
Topics: Animals; Aspergillosis; Conidiobolus; Cryptococcosis; Female; Goat Diseases; Goats; Sheep; Sheep Diseases; Zygomycosis
PubMed: 32921278
DOI: 10.1177/1040638720958338 -
Blood Aug 2011Unlike invasive aspergillosis, the prognosis and outcome of hematologic malignancy patients who develop invasive mucormycosis have not significantly improved over the... (Review)
Review
Unlike invasive aspergillosis, the prognosis and outcome of hematologic malignancy patients who develop invasive mucormycosis have not significantly improved over the past decade as a majority of patients who develop the infection still die 12 weeks after diagnosis. However, early recognition and treatment of invasive mucormycosis syndromes, as well as individualized approaches to treatment and secondary prophylaxis, could improve the odds of survival, even in the most persistently immunosuppressed patient receiving chemotherapy and/or of stem cell transplantation. Herein, we describe the subtle clinical and radiographic clues that should alert the hematologist to the possibility of mucormycosis, and aggressive and timely treatment approaches that may limit the spread of infection before it becomes fatal. Hematology patients with this opportunistic infection require integrated care across several disciplines and frequently highly individualized and complex sequence of decision-making. We also offer perspectives for the use of 2 antifungals, amphotericin B products and posaconazole, with activity against Mucorales. The availability of posaconazole in an oral formulation that can be administered safely for prolonged periods makes it an attractive agent for long-term primary and secondary prophylaxis. However, serum drug concentration monitoring may be required to minimize breakthrough infection or relapsing mucormycosis associated with inadequate blood concentrations.
Topics: Algorithms; Antifungal Agents; Aspergillosis; Comorbidity; Decision Making; Diagnosis, Differential; Hematologic Neoplasms; Humans; Models, Biological; Mucormycosis
PubMed: 21622653
DOI: 10.1182/blood-2011-03-316430