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Mucormycosis: Review on the basis of Diagnosis Treatment, Preventive Measures, and Recent Research Approach

Warude Bhagyashri, Gugale Prachi, Jadhav Manasi, Garud Aniket, Meshram Priti, S.N. Wagh


Mucormycosis is a fungal infection called an angio-invasive disease due to invasion of fungi of the order Mucorales and zygomatic species which causes tissue infarction and necrosis. The main aim and purpose of this review are related to the overview of Etiopathogenesis of Mucormycosis, mortality due to various types of Mucormycosis, recent advances in diagnostic and treatment methods, and their diagnostic preventive measures. It shows serious and worrying mortality and morbidity rates. The Etiopathogenesis of the disease remains different overall in the world and the diagnosis of the disease's appearance remains a critical role for the clinicians. It is a fatal fungal infection that mainly affects altered immunity patients and is mostly found in recent pandemic disease COVID-19 patients at recovery phase, also in people with high diabetics and taking prolonged corticosteroids. The liposomal Amphotericin-B (>5mg /kg) is the newest drug that is recommended as first-line therapy. Intravenous Isavuconazole and Posaconazole are delayed-release tablet forms used for patients intolerant to Amphotericin-B as a second-line of treatment. The review mentions the recent treatment and management of the Mucormycosis Viewpoints are however hopeful and promising for researchers for new drug therapy evaluating relationships between host, fungi, and antifungal drugs, immune-boosting agents and new routes of administration such as aerosols may improve mucormycosis treatment. Tests for identification include the Galactomannan test and the Beta Glucan test. Both these tests are found to be negative in the case of mucormycosis.


Mucormycosis, Isavuconazole, Posaconazole, Amphotericin B, antifungal drugs, Galactomannan, Beta-D-Glucan

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Kwon-Chung KJ. Taxonomy of fungi causing mucormycosis and entomophthoramycosis (zygomycosis) and nomenclature of the disease: molecular mycologic perspectives. Clinical Infectious Disease, 2012; 54(suppl_1): S8-15.

Mycosis mucorina. by Arnold PALTAUF. Georg Reimer (January 1, 1885)

Hariprasath Prakash, Arunaloke Chakrabarti. Epidemiology of Mucormycosis in India. Microorganisms 2021, 9(3), 523.

Anna Skiada, Ioannis Pavleas, Maria Drogari-Apiranthitou. Epidemiology and Diagnosis of Mucormycosis: An Update.J.Fungi(Basel), 2020 Dec, 6(4):265

Hibbett DS, Binder M, Bischoff JF, Meredith Blackwell, Paul F Cannon, Ove E Eriksson, Sabine Huhndorf, Timothy James, et al. A higher-level phylogenetic classification of the Fungi. Mycol Res. 2007; 111(Pt 5):509-47.

Prakash H, Ghosh A, Rudramurthy S, Paul R, Gupta S, Negi V, et al. The environmental source of emerging Apophysomyces variables infection in India. Med. Mycol. 2016:54(6):567-575. [PubMed]

Ramlingam Suganya, Narsimha Malathi, Vinithra Kartikeyan, Vyshanvi Devi Janagaraj. Mucormycosis: A Brief Review. March 2019. Journal of Pure and Applied Microbiology 13(1):161-165

Frater JL, Hall GS, Procop GW. Histologic features of zygomycosis: Emphasis on perineural invasion and fungal morphology. Arch. Pathol. Lab. Med. 2001:125(3):375-378.

Eucker J, Sezer O, Graf B, Possinger K. Mucormycosis. Mycoses. 2001; 44 (7-8): 253-260

Sugar AM, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. Fifth edition. New York, USA: Churchill Livingstone; 2000.

Jeong W, Keighley C, Wolfe R, Lee WL, Kong DCM, Slavin M A, Chen SCA. The epidemiology and clinical manifestation of mucormycosis: A systematic review and meta-analysis of case reports. Clin Microbiol. Infect. 2019, 25(1):26-34.

Hibbett DS, Binder M, Bischoff JF, Meredith Blackwell, Paul F Cannon, Ove E Eriksson, Sabinel Huhndorf, Timothy James, et al. A higher-level phylogenic classification of the Fungi. Mycol Res. 2007; 111(Pt 5):509-547.

Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele R L, Sein M, et al. Epidemiology and outcome of zygomycosis: A review of 929 reported cases. Clin. Infect. Dis. 2005, 41(5), 634-653 [PubMed]

Cornely OA, Alastruey-Izquierdo A, Arenz D, Chen SCA, Dannaoui E, et al; Mucormycosis ECMM MSG Global Guideline Writing Group. Global guideline for the diagnosis and management of mucormycosis; an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis. 2019 Dec; 19(12); e405-e421.

Ibrahim AS, Spellberg B, Walsh TJ, Kontoyiannis DP. Pathogenesis of mucormycosis. Clin Infect Dis 2012; 54 Suppl 1:S16.

Reid G, Lynch JP, Fishbein MC, Clark NM, Mucormycosis. Semin Respir Crit Care Med. 2020 Feb;41(1):99-114.

Chakrabarti A, Das A, Mandal J, Shivaprakash MR, George VK, Tarai B, Rao P, et al. The rising trend of invasive zygomycosis in patients with uncontrolled diabetes mellitus. Med. Mycol. 2006 Jun;44(4):335-42.

Patel A, Kaur H, Xess I, Michael J S, Savio J, Rudramurthy S, R Singh, et al. A multi-center observational study on the epidemiology. Infect. 2020, 26(7):944.e9-944.e15.

Ibrahim AS, Gebremariam T, Lin L, et al. The high affinity iron permease is a key virulence factor required for Rhizopus oryzae pathogenesis. Mol Microbiol. 2010;77:587–604.

Prakash M, Chakrabarti A, Global Epidemiology of Mucormycosis. J. Fungi 2019:5(1):26. [PubMed]

Skiada A, Pagano L, Groll A, Zimmerli S, Dupont B, Lagrou K, Bouza E, Klimko N, Gausted P, et al. Zygomycosis in Europe: Analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007. Clin Microbial. Infect. 2011:17(12):1859-1867.

Patel A K, Gohel S, Chakrabarti A, et al. Mucormycosis at a tertiary care center in Gujarat, India, Mycoses 2017, 60(6):407-711.

Pandey M, Agarwal R, Dabas Y, Jyotsna V P, Kumar R, Immaculata X, et al, Emerging Rhizopus microsporus Infections in India. J. Clin. Microbial 2018,56(6):1-5.

Lionakis MS, Kontoyiannis D P. Glucocorticoids and invasive fungal infections. Lancet 2003: 362(9398):1828-1838

Talmi Y P, Goldschmied- Reouven A, Bakon M, Iris Barshack, et al. Rhino-orbital, and rhino-orbito cerebral mucormycosis. Otolaryngol Head Neck Surg 2002; 127(1):22-31.

Funada H, Matsuda T. Pulmonary mucormycosis in a hematology ward. Intern Med 1996;35(7):540-544.

Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev 2005; 18(3):556-569

Pan American Health Organization / World Organization. Epidemiology Alert: COVID-19 associated Mucormycosis. 11 June 2021, Washington, D. C: Available online at:

Sarkar, Sandip; Gokhale, Tanmay; Choudhury, Sushmita Sana1; Deb, Amit Kumar.COVID-19 and orbital mucormycosis, Indian Journal of Ophthalmology: April 2021:69(4)p-1002-1004.

Russell E. Lewis, Guangling Liao, Weiqun Wang, Randall A. Prince & Dimitrios P. Kontoyiannis. Voriconazole pre-exposure selects for breakthrough mucormycosis in a mixed model of Aspergillus fumigatus-Rhizopus oryzae pulmonary infection, Virulence. Jul-Aug 2011;2(4):348-55.

Meyer Br, Wormser G, Hirschan S Z. Rhinocerebral mucormycosis: premortem diagnosis and therapy. Arch Intern. Med., 1979 May;139(5):557-60.

Szalai G, Fellegi V, Szabo Z, Vitez LC, Mucormycosis mimics sinusitis in a diabetic adult. Ann N Y Acad Sci.2006 Nov.1084:520-530. [Medline]

Torres-Narbona M, Guinea J, Martinez-Alarcon J, Munoz P, Gadea I, Bouza E. Impact of mucormycosis on microbiology overload: a survey study in Spain. PJ Clin Microbiol 2007; 45(6):2051-2053

Gonzalez C E, Rinaldi M G, Sugar A M. Zygomycosis. Infect Dis Clin North Am 2002 Dec; 16(4): 895-914, vi.

Hampson F G, Ridgway E J, Feeley K, Reilly J T. A fatal case of disseminated mucormycosis associated with the use of blood glucose self-monitoring equipment, J Infect 2005; 51(5): e269-272.

CDC. Mycotic Diseases Branch. Avialable online at:

mycotics/index.html Page last reviewed: February 25, 2021

Imhof A, Balajee S A, Fredricks D N, Englund J A, Marr K A. Breakthrough fungal infections in stem cell transplant recipients receiving voriconazole. Clin Infect Dis 2004; 39(5):743-746.

B R Chauhan, et al. Pulmonary mucormycosis. J Assoc Physicians India. 1998 Apr;46(4):396-7.

Rammaert B, Lanternier F, Kania R, Lortholary O. Diabetes and mucormycosis: a complex interplay. Diabetes & metabolism, 2012; 38(3):193-204.

Gale G R, Welch A M. Studies of opportunistic fungi. I. Inhibition of Rhizopus oryzae by human serum. M. J. Med. Sci., 241: 604-12

Tedder M, Spratt J A, Anstadt M P, Hedge SS, Tedder SD, Lowe J E. Pulmonary mucormycosis: results of medical and surgical therapy. Ann. Thorac Surg.., 1994; 57(4):1044-50.

Almyroudis N G, Sutton D A, Linden P, Rinaldi M G, Fung J, et al. Zygomycosis in solid organ transplant recipients in a tertiary transplant center and review of the literature. Am J Transplant 2006; 6(10):2365-2374

Lin E, Moua T, Limper AH, Pulmonary mucormycosis: clinical features and outcomes. Infection. 2017 Aug; 45(4): 443-448.

Jorge Hernandez, Mucormycosis. Available online at:

Library/viewarticle/25325 (7/25/2021)

Ibrahim AS, Gebremariam T, Fu Y. The iron chelator Deferasirox protects mice from mucormycosis through iron starvation. J Clin Invest 2007, 117(9):2649-2657.

Schowengerdt KO, Naftel DC, FB Pearce, E Frazier, G Toiler, Seib PM, et al. Infection after pediatric Heart transplantation: results of a multi-institutional study. J Heart Lung Transplant 1997; 16(12):1207-1216.

Nithyanandam S, Jacob MS, Battu RR, Thomas RK, Correa MA, DSouza O. Rhino-orbito cerebral mucormycosis. A retrospective analysis of clinical features and treatment outcomes. Ind. J. Ophthalmol.,2003; 51(3):231-236

Kalayjian R C, Herig R H, Cohen AM, Hutton M C. Thrombosis of the aorta caused by mucormycosis. South Med J 1988; 81(9): 1180-1182

Chawla N, Reddy S J, Agrawal M, IIeocolic mucormycosis causing intestinal obstruction. Indian J Med Microbial.2012 Jul- Sep. 30(3):373-374. [Medline].

Chaudhuri R, McKeown B, Harrington D, Hay R J, Bingham JB, Spencer J D, Mucormycosis osteomyelitis causing avascular necrosis of the cuboid bone: MR imaging findings. Am J Roentgenol 1992; 159(5): 1035-1037.



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