Mucormycosis and entomophthoramycosis: A review of the clinical manifestations, diagnosis and treatment

Clinical Microbiology and Infection

Volumn 10, Issue SUPPL. 1, 2004, Pages 31-47

  Prabhu, R M ^a   Patel, Robin ^a  

^a Mayo Clinic College of Medicine   (United States)

Author keywords

Apophysomyces; Basidiobolus; Conidiobolus; Entomophthorales; Entomophthoramycosis; Mucor; Mucorales; Mucormycosis; Rhizopus; Zygomycetes

Indexed keywords

AMPHOSIL; AMPHOTERICIN B; AMPHOTERICIN B CHOLESTEROL SULFATE; AMPHOTERICIN B DEOXYCHOLATE; AMPHOTERICIN B LIPID COMPLEX; CASPOFUNGIN; CIPROFLOXACIN; CORTICOSTEROID; COTRIMOXAZOLE; DEFEROXAMINE; FLUCONAZOLE; FLUCYTOSINE; GRANULOCYTE COLONY STIMULATING FACTOR; GRANULOCYTE MACROPHAGE COLONY STIMULATING FACTOR; ITRACONAZOLE; KETOCONAZOLE; MICONAZOLE; OXYGEN; POSACONAZOLE; POTASSIUM IODIDE; TERBINAFINE; TROVAFLOXACIN; VORICONAZOLE;

ABSIDIA; BASIDIOBOLUS; BONE MARROW TRANSPLANTATION; CUNNINGHAMELLA; DIABETES MELLITUS; DIABETIC KETOACIDOSIS; DISEASE PREDISPOSITION; EARLY DIAGNOSIS; ENTOMOPHTHORA; GASTROINTESTINAL INFECTION; HEAD AND NECK INFECTION; HEMATOLOGIC MALIGNANCY; HUMAN; IMMUNE DEFICIENCY; IMMUNOCOMPETENCE; INJURY; IRON OVERLOAD; LUNG INFECTION; MORTALITY; MUCOR; MUCORALES; MUCORMYCOSIS; NEUTROPENIA; ORGAN TRANSPLANTATION; OUTCOMES RESEARCH; PERIPHERAL BLOOD STEM CELL TRANSPLANTATION; PRIORITY JOURNAL; REVIEW; RHIZOMUCOR; RHIZOPUS; SKIN INFECTION; SOFT TISSUE INFECTION; TROPIC CLIMATE; ZYGOMYCETES;

ABSIDIA; APOPHYSOMYCES; BASIDIOBOLUS; CONIDIOBOLUS; CUNNINGHAMELLA; ENTOMOPHTHORALES; MUCOR; MUCORALES; RHIZOMUCOR; RHIZOPUS; SAKSENAEA; ZYGOMYCETES;

EID: 1642287033     PISSN: 1198743X     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1470-9465.2004.00843.x     Document Type: Article

References (194)

1. Herbrecht R, Letscher-Bru V, Bowden RA et al. Treatment of 21 cases of invasive mucormycosis with amphotericin B colloidal dispersion. Eur J Clin Microbiol Infect Dis 2001; 20: 460-6.
2. Sugar AM. Agents of mucormycosis and related species. In: Mandell, GI, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 5th edn. New York: Churchill Livingstone, 2000; 2685-95.
3. Eucker J, Sezer O, Graf B, Possinger K. Mucormycoses. Mycoses 2001; 44: 253-60.
4. Nosari A, Oreste P, Montillo M et al. Mucormycosis in hematologic malignancies: an emerging fungal infection. Haematologica 2000; 85: 1068-71.
5. Funada H, Matsuda T. Pulmonary mucormycosis in a hematology ward. Intern Med 1996; 35: 540-4.
6. Kontoyiannis DP, Wessel VC, Bodey GP, Rolston VI. Zygomycosis in the 1990s in a tertiary-care cancer center. Clin Infect Dis 2000; 30: 851-6.
7. Kamalam A, Thambiah AS. Cutaneous infection by Syncephalastrum. Sabouraudia 1980; 18: 19-20.
8. Kirkpatrick MB, Pollock HM, Wimberley NE, Bass JB, Davidson JR, Boyd BW. An intracavitary fungus ball composed of Syncephalastrum. Am Rev Respir Dis 1979; 120: 943-7.
9. Ribes JA, Vonover-Sams CL, Baker DJ. Zygomycetes in human disease. Clin Microbiol Rev 2000; 13: 236-301.
10. Parfrey NA. Improved diagnosis and prognosis of mucormycosis. A clinicopathologic study of 33 cases. Medicine 1986; 65: 113-23.
11. Lee FY, Mossad SB, Adal KA. Pulmonary mucormycosis: the last 30 years. Arch Intern Med 1999; 159: 1301-9.
12. Solano T, Atkins B, Tambosis E, Mann S, Gottlieb T. Disseminated mucormycosis due to Saksenaea vasiformis in an immunocompetent adult. Clin Infect Dis 2000; 30: 942-3.
13. Wall SJ, Lee KH, Alvarez JD, Bigelow DC. Quiz case 1. Cutaneous mucormycosis of the external ear. Arch Otolaryngol Head Neck Surg 2000; 126: 238-9.
14. Ingram CW, Sennesh J, Cooper JN, Perfect JR. Disseminated zygomycosis. Report of four cases and review. Rev Infect Dis 1989; 11: 741-54.
15. Tedder M, Spratt JA, Anstadt MP, Hegde SS, Tedder SD, Lowe JE. Pulmonary mucormycosis: results of medical and surgical therapy. Ann Thorac Surg 1994; 57: 1044-50.
16. Chakrabarti A, Das A, Sharma A et al. Ten years' experience in zygomycosis at a tertiary care centre in India. J Infect 2001; 42: 261-6.
17. Chakrabarti A, Kumar P, Padhye AA et al. Primary cutaneous zygomycosis due to Saksenaea vasiformis and Apophysomyces elegans. Clin Infect Dis 1997; 24: 580-3.
18. Espinel-Ingroff A, Oakley LA, Kerkering TM. Opportunistic zygomycotic infections. Mycopathologia 1987; 97: 33-41.
19. Meyer RD, Rosen P, Armstrong D. Phycomycosis complicating leukemia and lymphoma. Ann Intern Med 1972; 77: 871-9.
20. Baddley JW, Stroud TP, Salzman D, Pappas PG. Invasive mold infections in allogeneic bone marrow transplant recipients. Clin Infect Dis 2001; 32: 1319-24.
21. Maertens J, Demuynck H, Verbeken EK et al. Mucormycosis in allogenic bone marrow transplant recipients: report of five cases and review of the role of iron overload in the pathogenesis. Bone Marrow Transplant 1999; 24: 307-12.
22. Morrison VA, McGlave PB. Mucormycosis in the BMT population. Bone Marrow Transplant 1993; 11: 383-8.
23. Penalver FJ, Romero R, Fores R, Cabrera R, Briz M, Fernandez M. Mucormycosis and hemopoietic transplants. Haematologica 1998; 83: 950-1.
24. Wajszczuk CP, Dummer JS, Ho M, Van Thiel TE, Iwatsuki S, Shaw B. Fungal infections in liver transplant recipients. Transplantation 1985; 40: 347-53.
25. Maurer J, Tullis E, Grossman RF, Vellend H, Winton TL, Patterson A. Infectious complications following isolated lung transplantation. Chest 1992; 101: 1056-9.
26. Chkhotua A, Yussim A, Tovar A et al. Mucormycosis of the renal allograft: case report and review of the literature. Transpl Int 2001; 14: 438-41.
27. Jimenez C, Lumbreras C, Aguado JM et al. Successful treatment of Mucor infection after liver or pancreas-kidney transplantation. Transplantation 2002; 73: 476-80.
28. Castaldo P, Stratta RJ, Wood P et al. Clinical spectrum of fungal infections after orthotopic liver transplantation. Arch Surg 1991; 126: 149-56.
29. Grossi P, Farina C, Fiocchi R, Gasperina DD. Prevalence and outcome of invasive fungal infections in 1,963 thoracic organ transplant recipients: a multicenter retrospective study. Transplantation 2000; 70: 112-16.
30. Ko WJ, Chien NC, Chou NK, Chu SH, Chang SC. Infection in heart transplant recipients: Seven years' experience at the national Taiwan University hospital. Transplant Proc 2000; 32: 2392-5.
31. Schowengerdt KO, Naftel DC, Seib PM et al. Infection after pediatric heart transplantation: Results of a multi-institutional study. J Heart Lung Transplant 1997; 16: 1207-16.
32. Ruffini E, Baldi S, Rapellino M et al. Fungal infections in lung transplantation. Incidence, risk factors and prognostic significance. Sarcoidosis Vasc Diffuse Lung Dis 2001; 18: 181-90.
33. Bertocchi M, Thevenet F, Bastien O et al. Fungal infections in lung transplant recipients. Transplant Proc 1995; 27: 1695.
34. Hofflin JM, Potasman I, Baldwin JC, Oyer PE, Stinson EB, Remington JS. Infectious complications in heart transplant recipients receiving cyclosporine and corticosteroids. Ann Intern Med 1987; 106: 209-16.
35. Miller LW, Naftel DC, Bourge RC et al. Infection after heart transplantation: a multi-institutional study. Transplantation 1994; 13: 381-93.
36. Nampoory MR, Khan ZU, Johny KV et al. Invasive fungal infections in renal transplant recipients. J Infect 1996; 33: 95-101.
37. Patel R, Potela D, Badley AD et al. Risk factors of invasive Candida and non-Candida fungal infections after liver transplantation. Transplantation 1996; 62: 926-34.
38. Chugh KS, Sakhuja V, Jain S et al. High mortality in systemic fungal infections following renal transplantation in third-world countries. Nephrol Dial Transplant 1993; 8: 168-72.
39. Morduchowicz G, Shmueli D, Shapira Z et al. Rhinocerebral mucormycosis in renal transplant recipients: report of three cases and review of the literature. Rev Infect Dis 1986; 8: 441-6.
40. Singh N, Gayowski T, Singh J, Yu VL. Invasive gastrointestinal zygomycosis in a liver transplant recipient: case report and review of zygomycosis in solid-organ transplant recipients. Clin Infect Dis 1995; 20: 617-20.
41. Talmi YP, Goldschmeid-Reouven A, Bakon M et al. Rhino-orbital and rhino-orbito-cerebral mucormycosis. Otolaryngol Head Neck Surg 2002; 127: 22-31.
42. Adriaenssens K, Jorens PG, Meuleman L, Jeuris W, Lambert J. A black necrotic skin lesion in an immunocompromised patient. Diagnosis: cutaneous mucormycosis. Arch Dermatol 2000; 136: 1165-70.
43. Michalak DM, Cooney DR, Rhodes KH, Telander RL, Kleinberg F. Gastrointestinal mucormycosis in infants and children: a cause of gangrenous intestinal cellulitis and perforation. J Pediatr Surg 1980; 15: 320-4.
44. Forbes BA, Sahm DF, Weissfeld AS. Bailey and Scott's Diagnostic Microbiology, 10th edn. New York: Mosby, 1998.
45. Sugar AM. Mucormycosis. Clin Infect Dis 1992; 14: S126-9.
46. Holland J. Emerging zygomycoses of humans: Saksenaea vasiformis and Apophysomyces elegans. Curr Top Med Mycol 1997; 8: 27-34.
47. Berns JS, Lederman MM, Greene BM. Nonsurgical cure of pulmonary mucormycosis. Am J Med Sci 1984; 287: 42-4.
48. Frater JL, Hall GS, Procop GW. Histologic features of zygomycosis: emphasis on perineural invasion and fungal morphology. Arch Pathol Lab Med 2001; 125: 375-8.
49. Garcia-Covarrubias L, Bartlett R, Barratt DM, Wassermann RJ. Rhino-orbito-cerebral mucormycosis attributable to Apophysomyces elegans in an immunocompetent individual: case report and review of the literature. J Trauma 2001; 50: 353-7.
50. Ferguson BJ, Camporesi EM, Farmer J. Adjunctive hyperbaric oxygen for treatment of rhinocerebral mucormycosis. Rev Infect Dis 1988; 10: 551-9.
51. Van Cutsem J, Van Gerven F, Fransen J, Janssen PA. Treatment of experimental zygomycosis in guinea pigs with azoles and with amphotericin B. Chemotherapy 1989; 35: 267-72.
52. McLean FM, Ginsberg LE, Stanton CA. Perineural spread of rhinocerebral mucormycosis. Am J Neuroradiol 1996; 17: 114-16.
53. Stefani FH, Mehraein P. Acute rhino-orbito-cerebral mucormycosis. Ophthalmologica 1976; 172: 38-44.
54. Kalayjian RC, Herzig RH, Cohen AM, Hutton MC. Thrombosis of the aorta caused by mucormycosis. South Med J 1988; 81: 1180-2.
55. Mileshkin L, Slavin M, Seymour JF, McKenzie A. Successful treatment of rhinocerebral zygomycosis using liposomal nystatin. Leuk Lymphoma 2001; 42: 1119-23.
56. Baraia J, Munoz P, Bernaldo de Quiros JC, Bouza E. Cutaneous mucormycosis in a heart transplant patient associated with a peripheral catheter. Eur J Clin Microbiol Infect Dis 1995; 14: 813-15.
57. Stas KJ, Louwagie PG, Van Damme BJ, Coosemans W, Waer M, Vanrenterghem YF. Isolated zygomycosis in a bought living unrelated kidney transplant. Transpl Int 1996; 9: 600-2.
58. Latif S, Saffarian N, Bellovich K, Provenzano R. Pulmonary mucormycosis in diabetic renal allograft recipients. Am J Kidney Dis 1997; 29: 461-4.
59. Jimenez C, Lumbreras C, Paseiro G et al. Treatment of Mucor infection after liver or pancreas-kidney transplantation. Transplant Proc 2002; 34: 82-3.
60. Boelaert JR, Fenves AZ, Coburn JW. Mucormycosis among patients on dialysis. N Engl J Med 1989; 321: 190-1.
61. Daly AL, Velazquez LA, Bradley SF, Kauffman CA. Mucormycosis: association with deferoxamine therapy. Am J Med 1989; 87: 468-71.
62. Boelaert JR, de Locht M, Van Cutsem J et al. Mucormycosis during deferoxamine therapy is a siderophore-mediated infection. In vitro and in vivo animal studies. J Clin Invest 1993; 91: 1979-86.
63. Virmani R, Connor DH, McAllister HA. Cardiac mucormycosis. A report of five patients and review of 14 previously reported cases. Am J Clin Pathol 1982; 78: 42-7.
64. McNab AA, McKelvie P. Iron overload is a risk factor for zygomycosis. Arch Ophthalmol 1997; 115: 919-21.
65. Abe F, Inaba H, Katoh T, Hotchi M. Effects of iron and desferrioxamine on Rhizopus infection. Mycopathologia 1990; 110: 87-90.
66. Artis WM, Fountain JA, Delcher HK, Jones HE. A mechanism of susceptibility to mucormycosis in diabetic ketoacidosis: transferrin and iron availability. Diabetes 1982; 31: 1109-14.
67. Mowat AG, Baum J. Chemotaxis of polymorphonucelar leukocytes from patients with diabetes mellitus. N Engl J Med 1971; 284: 621-7.
68. Waldorf AR, Ruderman N, Diamond RD. Specific susceptibility to mucormycosis in murine diabetes and bronchoalveolar macrophage defense against Rhizopus. J Clin Invest 1984; 74: 150-60.
69. Waldorf AR, Levitz SM, Diamond RD. In vivo bronchoalveolar macrophage defense against Rhizopus oryzae and Aspergillus fumigatus. J Infect Dis 1984; 150: 752-60.
70. Van den Saffele JK, Boelaert JR. Zygomycosis in HIV-positive patients: a review of the literature. Mycoses 1996; 39: 77-84.
71. Hejny C, Kerrison JB, Newman NJ, Stone CM. Rhino-orbital mucormycosis in a patient with acquired immunodeficiency syndrome (AIDS) and neutropenia. Am J Ophthalmol 2001; 132: 111-12.
72. Hopkins RJ, Rothman M, Fiore A, Goldblum SE. Cerebral mucormycosis associated with intravenous drug use: three case reports and review. Clin Infect Dis 1994; 19: 1133-7.
73. Wilson AP, Wright S, Bellingan G. Disseminated fungal infection following falciparum malaria. J Infect 2000; 40: 202-4.
74. Ruhnke M, Eichenauer E, Searle J, Lippek F. Fulminant tracheobronchial and pulmonary aspergillosis complicating imported Plasmodium falciparum malaria in an apparently immunocompetent woman. Clin Infect Dis 2000; 30: 938-40.
75. Hocqueloux L, Bruneel F, Pages CL, Vachon F. Fatal invasive aspergillosis complicating severe Plasmodium falciparum malaria. Clin Infect Dis 2000; 30: 940-2.
76. Lehrer RI, Howard DH et al. Mucormycosis. Ann Intern Med 1980; 9: 93-108.
77. Yohai RA, Bullock JD, Aziz AA, Markert RJ. Survival factors in rhino-orbital-cerebral mucormycosis. Surv Ophthalmol 1994; 39: 3-22.
78. Ferry AP, Abedi S. Diagnosis and management of rhino-orbito-cerebral mucormycosis (phycomycosis). A report of 16 personally observed cases. Ophthalmology 1983; 90: 1096-104.
79. Ericsson M, Anniko M, Gustafsson H, Hjalt CA, Stenling R, Tarnvik A. A case of chronic progressive rhinocerebral mucormycosis treated with liposomal amphotericin B and surgery. Clin Infect Dis 1993; 16: 585-6.
80. Ruoppi P, Dietz A, Nikanne E, Seppa J, Markkanen H, Nuutinen J. Paranasal sinus mucormycosis: a report of two cases. Acta Otolaryngol 2001; 121: 948-52.
81. Harrill WC, Stewart MG, Lee AG, Cernoch P. Chronic rhinocerebral mucormycosis. Laryngoscope 1996; 106: 1292-7.
82. Eucker J, Sezer O, Lehmann R et al. Disseminated mucormycosis caused by Absidia corymbifera leading to cerebral vasculitis. Infection 2000; 28: 246-50.
83. Anand A, Anand N. Rhinocerebral mucormycosis: cure without surgery? Arch Intern Med 1996; 156: 2269.
84. Gollard R, Rabb C, Larsen R, Chandrasoma P. Isolated cerebral mucormycosis: case report and therapeutic considerations. Neurosurgery 1994; 34: 174-7.
85. Blitzer A, Lawson W, Meyers BR, Biller HF. Patient survival factors in paranasal sinus mucormycosis. Laryngoscope 1980; 90: 635-48.
86. Raj P, Vella EJ, Bickerton RC. Successful treatment of rhinocerebral mucormycosis by a combination of aggressive surgical debridement and the use of systemic liposomal amphotericin B and local therapy with nebulized amphotericin - a case report. J Laryngol Otol 1998; 112: 367-70.
87. Bigby TD, Serota ML, Tierney LM Jr, Matthay MA. Clinical spectrum of pulmonary mucormycosis. Chest 1986; 89: 435-9.
88. Glazer M, Nusair S, Breuer R, Lafair J, Sherman Y, Berkman N. The role of BAL in the diagnosis of pulmonary mucormycosis. Chest 2000; 117: 279-82.
89. Nolan RL, Carter RR 3rd, Griffith JE, Chapman SW. Subacute disseminated mucormycosis in a diabetic male. Am J Med Sci 1989; 298: 252-5.
90. McAdams HP, Rosado de Christenson M, Strollo DC, Patz EF Jr. Pulmonary mucormycosis: radiologic findings in 32 cases. AJR Am J Roentgenol 1997; 168: 1541-8.
91. Donohue JF. Endobronchial mucormycosis. Chest 1983; 83: 585.
92. Donohue JF, Scott RJ, Walker DH, Bromberg PA. Phycomycosis: a cause of bronchial obstruction. South Med J 1980; 73: 734-6.
93. Maddox L, Long GD, Vredenburgh JJ, Folz RJ. Rhizopus presenting as an endobronchial obstruction following bone marrow transplant. Bone Marrow Transplant 2001; 28: 634-6.
94. Wanishsawad C, Kimbrough RC, Chinratanalab S, Nugent K. Mucormycotic osteolytic rib lesion presenting as subacute pleural effusion. Clin Infect Dis 1996; 22:715-16.
95. Funada H, Misawa T, Nakao S, Saga T, Hattori KI. The air crescent sign of invasive pulmonary mucormycosis in acute leukemia. Cancer 1984; 53: 2721-3.
96. Record NB, Ginder DR. Pulmonary phycomycosis without obvious predisposing factors. JAMA 1976; 235: 1256-7.
97. Yokoi S, Iizasa T, Yoshida S et al. Case report. Localized pulmonary zygomycosis without pre-existing immunocompromised status. Mycoses 1999; 42: 675-7.
98. Zeilender S, Drenning D, Glauser FL, Bechard D. Fatal Cunninghamella bertholletiae infection in an immunocompetent patient. Chest 1990; 97: 1482-3.
99. Ma B, Seymour JF, Januszewicz H, Slavin MA. Cure of pulmonary Rhizomucor pusillus infection in a patient with hairy-cell leukemia. Role of liposomal amphotericin B and GM-CSF. Leuk Lymphoma 2001; 42: 1393-9.
100. O'Connell MA, Pluss JL, Schkade P, Henry AR, Goodman DL. Rhizopus-induced hypersensitivity pneumonitis in a tractor driver. J Allergy Clin Immunol 1995; 95: 779-80.
101. Jain JK, Markowitz A, Khilanani PV, Lauter CB. Case report: localized mucormycosis following intramuscular corticosteroid. Case report and review of the literature. Am J Med Sci 1978; 275: 209-16.
102. Adam RD, Hunter G, DiTomasso J, Comerci G Jr. Mucormycosis: emerging prominence of cutaneous infections. Clin Infect Dis 1994; 19: 67-76.
103. Vainrub B, Macareno A, Mandel S, Musher DM. Wound zygomycosis (mucormycosis) in otherwise healthy adults. Am J Med 1988; 84: 546-8.
104. Cooter RD, Lim IS, Ellis DH, Leitch IOW. Burn wound zygomycosis caused by Apophysomyces elegans. J Clin Microbiol 1990, 2151-3.
105. Caceres AM, Sardinas C, Marcano C et al. Apophysomyces elegans limb infection with a favorable outcome: case report and review. Clin Infect Dis 1997; 25: 331-2.
106. Kimura M, Smith MB, McGinnis MR. Zygomycosis due to Apophysomyces elegans. Report of 2 cases and review of the literature. Arch Pathol Lab Med 1999; 123: 386-90.
107. Kobayashi M, Hiruma M, Matsushita A, Kawai M, Ogawa H, Udagawa S. Cutaneous zygomycosis: A case report and review of Japanese reports. Mycoses 2001; 44: 311-15.
108. Burrell SR, Ostlie DJ, Saubolle M, Dimler M, Barbour SD. Apophysomyces elegans infection associated with cactus spine injury in an immunocompetent pediatric patient. Pediatr Infect Dis J 1998; 17: 663-4.
109. Blair JE, Fredrikson LJ, Pockaj BA, Lucaire CS. Locally invasive cutaneous Apophysomyces elegans infection acquired from snapdragon patch test. Mayo Clin Proc 2002; 77: 717-20.
110. Carpenter CF, Subramanian AK. Images in clinical medicine. Cutaneous zygomycosis (mucormycosis). N Engl J Med 1999; 341: 1891.
111. Hata TR, Johnson RA, Barnhill R, Dover JS. Ecthyma-like lesions on the leg of an immunocompromised patient. Primary cutaneous mucormycosis. Arch Dermatol 1995; 131: 833-4; 836-7.
112. Cocanour CS, Miller-Crotchett P, Reed RL, Johnson PC, Fischer RP. Mucormycosis in trauma patients. J Trauma 1992; 32: 12-15.
113. Gartenberg G, Bottone EJ, Keusch GT, Weitzman I. Hospital-acquired mucormycosis (Rhizopus rhizopodiformis) of skin and subcutaneous tissue: Epidemiology, mycology and treatment. N Engl J Med 1978; 299: 1115-18.
114. Meis JF, Kullberg BJ, Pruszczynski M, Veth RP. Severe osteomyelitis due to the zygomycetes Apophysomyces elegans. J Clin Microbiol 1994; 32: 3078-81.
115. Eaton ME, Padhye AA, Schwartz DA, Steinberg JP. Osteomyelitis of the sternum caused by Apophysomyces elegans. J Clin Microbiol 1994; 32: 2827-8.
116. Keys TF, Haldorson AM, Rhodes KH, Roberts GD, Fifer EZ. Nosocomial outbreak of Rhizopus infections associated with elastoplast wound dressing. Minnesota Morb Mort Wkly Rep 1978; 27: 33-4.
117. Pagano L, Ricci P, Tonso A et al. Mucormycosis in patients with haematological malignancies: a retrospective clinical study of 37 cases. GIMEMA infection program (Gruppo Italiano Malattie Ematologiche Maligne Dell'adulto). Br J Haematol 1997; 99: 331-6.
118. Martinez EJ, Cancio MR, Sinnott J, Tt Vincent AL, Brantley SG. Nonfatal gastric mucormycosis in a renal transplant recipient. South Med J 1997; 90: 341-4.
119. Calle S, Klatsky S. Intestinal phycomycosis (mucormycosis). Am J Clin Pathol 1966; 45: 264-72.
120. Vera A, Stefan H, McMaster P, Buckels JAC. Invasive gastrointestinal zygomycosis in a liver transplant recipient: case report. Transplantation 2002; 73: 145-7.
121. Parra R, Arnau E, Julia A, Lopez A, Nadal A, Allende E. Survival after intestinal mucormycosis in acute myelogenous leukemia. Cancer 1986; 58: 2717-19.
122. Paulo De Oliveira JE, Milech A. A fatal case of gastric mucormycosis and diabetic ketoacidosis. Endocr Pract 2002; 8: 44-6.
123. Al-Rikabi AC, Al-Dohayan AD, Al-Boukai AA. Invasive mucormycosis in benign gastric ulcer. Saudi Med J 2000; 21: 287-90.
124. Vadeboncoeur C, Walton JM, Raisen J, Soucy P, Lau H, Rubin S. Gastrointestinal mucormycosis causing an acute abdomen in the immunocompromised pediatric patient - three cases. J Pediatr Surg 1994; 29: 1248-9.
125. Winkler S, Susani S, Willinger B et al. Gastric mucormycosis due to Rhizopus oryzae in a renal transplant recipient. J Clin Microbiol 1996; 34: 2585-7.
126. Sheu BS, Lee PC, Yang HB. A giant gastric ulcer caused by mucormycosis infection in a patient with renal transplantation. Endoscopy 1998; 30: S60-1.
127. Barroso F, Forcelledo JL, Mayorga M, Pena F, Marques FF, de la Pena J. A fatal case of gastric mucormycosis in a heart transplant recipient. Endoscopy 1999; 31: S2.
128. Oliver MR, Van Voorhis WC, Boeckh M, Mattson D, Bowden RA. Hepatic mucormycosis in a bone marrow transplant recipient who ingested naturopathic medicine. Clin Infect Dis 1996; 22: 521-4.
129. Corley DA, Lindeman N, Ostroff JW. Survival with early diagnosis of invasive gastric mucormycosis in a heart transplant patient. Gastrointest Endosc 1997; 46: 452-4.
130. Sanchez-Recalde A, Merino JL, Dominguez F, Mate I, Larrea JL, Sobrino JA. Successful treatment of prosthetic aortic valve mucormycosis. Chest 1999; 116: 1818-20.
131. Mishra B, Mandal A, Kumar N. Mycotic prosthetic-valve endocarditis. J Hosp Infect 1992; 20: 122-5.
132. Zhang R, Zhang JW, Szerlip HM. Endocarditis and hemorrhagic stroke caused by Cunninghamella bertholletiae infection after kidney transplantation. Am J Kidney Dis 2002; 40: 842-6.
133. Weng DE, Wilson WH, Little R, Walsh TJ. Successful medical management of isolated renal zygomycosis: case report and review. Clin Infect Dis 1998; 26: 601-5.
134. Burke WV, Zych GA. Fungal infection following replacement of the anterior cruciate ligament: A case report. J Bone Joint Surg Am 2002; 84A: 449-53.
135. Pierce PP, Wood MB, Roberts GD, Fitzgerald RH, Robertson. C, Edson RS. Saksenaea vasiformis osteomyelitis. J Clin Microbiol 1987; 25: 933-5.
136. Holtom PD, Obuch AB, Ahlmann ER, Shepherd LE, Patzakis MJ. Mucormycosis of the tibia: A case report and review of the literature. Clin Orthop 2000; 381: 222-8.
137. Chaudhuri R, McKeown B, Harrington D, Hay RJ, Bingham JB, Spencer JD. Mucormycosis osteomyelitis causing avascular necrosis of the cuboid bone: Mr imaging findings. Am J Roentgenol 1992; 159: 1035-7.
138. Echols RM, Selinger DS, Hallowell C, Goodwin JS, Duncan MH, Cushing AH. Rhizopus osteomyelitis. A case report and review. Am J Med 1979; 66: 141-5.
139. Einsele H, Hebart H, Roller G et al. Detection and identification of fungal pathogens in blood by using molecular probes. J Clin Microbiol 1997; 35: 1353-60.
140. Rickerts V, Loeffler J, Bohme A, Einsele H, Just-Nubling G. Diagnosis of disseminated zygomycosis using a polymerase chain reaction assay. Eur J Clin Microbiol Infect Dis 2001; 20: 744-5.
141. Roy V, Ali LI, Carter TH, Selby GB. Successful non-surgical treatment of disseminated polymicrobial fungal infection in a patient with pancytopenia and graft-versus-host disease. J Infect 2000; 41: 273-5.
142. Garey KW, Pendland SL, Huynh VT, Bunch TH, Jensen GM, Pursell KJ. Cunninghamella bertholletiae infection in a bone marrow transplant patient: amphotericin lung penetration, MIC determinations, and review of the literature. Pharmacotherapy 2001; 21: 855-60.
143. Kocak R, Tetiker T, Kocak M, Baslamisli F, Zorludemir S, Gonlusen G. Fluconazole in the treatment of three cases of mucormycosis. Eur J Clin Microbiol Infect Dis 1995; 14: 559-61.
144. Funada H, Miyake Y, Kanamori K, Okafuji K, Machi T, Matsuda T. Fluconazole therapy for pulmonary mucormycosis complicating acute leukemia. Jpn J Med 1989; 28: 228-31.
145. Mosquera J, Warn PA, Rodriguez-Tudela JL, Denning DW. Treatment of Absidia corymbifera infection in mice with amphotericin B and itraconazole. J Antimicrob Chemother 2001; 48: 583-6.
146. Mendoza-Ayala R, Tapia R, Salathe M. Spontaneously resolving pulmonary mucormycosis. Clin Infect Dis 1999; 29: 1335-6.
147. Odds FC, Van Gerven F, Espinel-Ingroff A et al. Evaluation of possible correlations between antifungal susceptibilities of filamentous fungi in vitro and antifungal treatment outcomes in animal infection models. Antimicrob Agents Chemother 1998; 42: 282-8.
148. Sun QN, Fothergill AW, McCarthy DI, Rinaldi MG, Graybill JR. In vitro activities of posaconazole, itraconazole, voriconazole, amphotericin B, and fluconazole against 37 clinical isolates of zygomycetes. Antimicrob Agents Chemother 2002; 46: 1581-2.
149. Pfaller MA, Messer SA, Hollis RJ, Jones RN and the Sentry Participants Group. Antifungal activities of posaconazole, ravuconazole, and voriconazole compared to those of itraconazole and amphotericin B against 239 clinical isolates of Aspergillus spp. and other filamentous fungi: report from sentry antimicrobial surveillence program, 2000. Antimicrob Agents Chemother 2002; 46: 1032-7.
150. Gomez-Lopez A, Cuenca-Estrella M, Monzon A, Rodriguez-Tudela JL. In vitro susceptibilities of clinical isolates of Zygomycota to amphotericin B, flucytosine, itraconazole, and voriconazole. J Antimicrob Chemother 2001; 48: 919-21.
151. Sugar AM, Liu XP. Combination antifungal therapy in treatment of murine pulmonary mucormycosis: roles of quinolones and azoles. Antimicrob Agents Chemother 2000; 44: 2004-6.
152. Abraham P, Govil S, Srivastava VM, Ganesh A. Spontaneous regression of pulmonary mucormycosis. Postgrad Med J 1995; 71: 632-4.
153. Sahin B, Paydas S, Cosar E, Bicakci K, Hazar B. Role of granulocyte colony-stimulating factor in the treatment of mucormycosis. Eur J Clin Microbiol Infect Dis 1996; 15: 866-9.
154. MacKenzie KM, Baumgarten KL, Helm BM et al. Innovative medical management with resection for successful treatment of pulmonary mucormycosis despite diagnostic delay. J State Med Soc 2002; 154: 82-5.
155. Garcia-Diaz JB, Palau L, Pankey GA. Resolution of rhinocerebral zygomycosis associated with adjuvant administration of granulocyte-macrophage colony-stimulating factor. Clin Infect Dis 2001; 32: 145-50.
156. Oo MM, Kutteh LA, Koc ON, Strauss M, Lazarus HM. Mucormycosis of petrous bone in an allogeneic stem cell transplant recipient. Clin Infect Dis 1998; 27: 1546-7.
157. Pelton RW, Peterson EA, Patel BC, Davis K. Successful treatment of rhino-orbital mucormycosis without exenteration: the use of multiple treatment modalities. Ophthal Plast Reconstr Surg 2001; 17: 62-6.
158. Scalise A, Barchiesi F, Viviani MA, Arzeni D, Bertani A, Scalise G. Infection due to Absidia corymbifera in a patient with a massive crush trauma of the foot. J Infect 1999; 38: 191-2.
159. Bentur Y, Shupak A, Ramon Y et al. Hyperbaric oxygen therapy for cutaneous/soft-tissue zygomycosis complicating diabetes mellitus. Plast Reconstr Surg 1998; 102: 822-4.
160. Okhuysen PC, Rex JH, Kapusta M, Fife C. Successful treatment of extensive posttraumatic soft-tissue and renal infections due to Apophysomyces elegans. Clin Infect Dis 1994; 19: 329-31.
161. De La Paz MA, Patrinely JR, Marines HM, Appling WD. Adjunctive hyperbaric oxygen in the treatment of bilateral cerebro-rhino-orbital mucormycosis. Am J Ophthalmol 1992; 114: 208-11.
162. Couch L, Theilen F, Mader JT. Rhinocerebral mucormycosis with cerebral extension successfully treated with adjunctive hyperbaric oxygen therapy. Arch Otolaryngol Head Neck Surg 1988; 114: 791-4.
163. Price JC, Stevens DL. Hyperbaric oxygen in the treatment of rhinocerebral mucormycosis. Laryngoscope 1980; 90: 737-47.
164. Gudewicz TM, Mader JT, Davis CP. Combined effect of hyperbaric oxygen and antifungal agents on the growth of Candida albicans. Aviat Space Environ Med 1987; 58: 673-8.
165. Park MK, Myers AM, Marzella L. Oxygen tensions and infections: modulation of microbial growth, activity of antimicrobial agents, and immunologic responses. Clin Infect Dis 1992; 14: 720-40.
166. Barratt DM, Van Meter K, Asmar P et al. Hyperbaric oxygen as an adjunct in zygomycosis: randomized controlled trial in a murine model. Antimicrob Agents Chemother 2001; 45: 3601-2.
167. Gugnani HC. A review of zygomycosis due to Basidiobolus ranarum. Eur J Epidemiol 1999; 15: 923-9.
168. Williams AO. Pathology of phycomycosis due to Entomophthora and Basidiobolus species. Arch Pathol 1969; 87: 13-20.
169. Yousef OM, Smilack JD, Kerr DM, Ramsey R, Rosati L, Colby TV. Gastrointestinal basidiobolomycosis: morphologic findings in a cluster of six cases. Clin Infect Dis 1999; 112: 610-16.
170. Schmidt JH, Howard RJ, Chen JL, Pierson K. First culture-proven gastrointestinal entomophthoromycosis in the United States: a case report and review of the literature. Mycopathologia 1986; 95: 101-4.
171. Zavasky D, Samowitz W, Loftus T, Segal H, Carroll K. Gastrointestinal zygomycotic infection caused by Basidiobolus ranarum: Case report and review. Clin Infect Dis 1999; 28: 1244-8.
172. Mugerwa JW. Subcutaneous phycomycosis in Uganda. Br J Dermatol 1976; 94: 539-44.
173. Foss NT, Rocha MRO, Lima VTA, Velludo MASL, Roselino AMF. Entomophthoramycosis: Therapeutic success using amphotericin B and terbinafine. Dermatology 1996; 193: 258-60.
174. Bittencourt AL, Londero AT, Araujo MDGS, Mendonca N, Bastos JLA. Occurence of subcutaneous zygomycosis caused by Basidiobolus haptosporus in Brazil. Mycopathologia 1979; 68: 101-4.
175. Krishnan SGS, Sentamilselvi G, Kamalam A, Das A, Janaki C. Entomophthoromycosis in India - a 4-year study. Mycoses 1998; 41: 55-8.
176. Smilack JD. Gastrointestinal basidiobolomycosis. Clin Infect Dis 1998; 27: 663-4.
177. Khan ZU, Prakash B, Kapoor MM, Madda JP, Chandy R. Basidiobolomycosis of the rectum masquerading as Crohn's disease. Case report and review. Clin Infect Dis 1998; 26: 521-3.
178. Khan ZU, Khoursheed M, Makar R et al. Basidiobolus ranarum as an etiologic agent of gastrointestinal zygomycosis. J Clin Microbiol 2001; 39: 2360-3.
179. Lyon GM, Smilack JD, Komatsu KK et al. Gastrointestinal basidiobolomycosis in Arizona: clinical and epidemiological characteristics and review of the literature. Clin Infect Dis 2001; 32: 1448-55.
180. Dworzack DL, Pollock AS, Hodges GR, Barnes WG, Ajello L, Padhye A. Zygomycosis of the maxillary sinus and palate caused by Basidiobolus haptosporus. Arch Intern Med 1978; 138: 1274-6.
181. Taylor GD, Sekhon AS, Tyrrell LJ, Goldsand G. Rhinofacial zygomycosis caused by Conidiobolus coronatus: a case report including in vitro sensitivity to antimycotic agents. Am J Trop Med Hyg 1987; 36: 398-401.
182. Lithander J, Louon A, Scrimgeour E. Orbital entomophthoramycosis in an infant: recovery following surgical debridement, combination antifungal therapy and use of hyperbaric oxygen. Br J Ophthalmol 2001; 85: 374-5.
183. Al-Hajjar S, Perfect J, Hashem F, Tufenkeji H, Kayes S. Orbitofascial conidiobolomycosis in a child. Pediatr Infect Dis J 1996; 15: 1130-2.
184. Ochoa LF, Dubque CS, Velez A. Rhinoentomophthoromycosis. Report of two cases. J Laryngol Otol 1996; 110: 1154-6.
185. Su WF, Lin JK, Nieh S. Entomophthora coronata infection of the paranasal sinuses: report of a case. J Oral Maxillofac Surg 1997; 55: 1158-61.
186. Jaffey PB, Haque AK, El-Zaatari M, Pasarell L, McGinnis MR. Disseminated Conidiobolus infection with endocarditis in a cocaine abuser. Arch Pathol Lab Med 1990, 114.
187. Walsh TJ, Renshaw G, Andrews J et al. Invasive zygomycosis due to Conidiobolus incongruus. Clin Infect Dis 1994; 19: 423-30.
188. Kaufman L, Mendoza L, Standard PC. Immunodiffusion test for serodiagnosing subcutaneous zygomycosis. J Clin Microbiol 1990: 28: 1887-90.
189. Guarro J, Aguilar C, Pujol I. In-vitro antifungal susceptibilities of Basidiobolus and Conidiobolus spp. strains. J Antimicrob Chemother 1999; 44: 557-60.
190. Stasser M, Kennedy RJ, Adam RD. Rhinocerebral mucormycosis: therapy with amphotericin B lipid complex. Arch Intern Med 1996; 156: 337-9.
191. Tobon AM, Arango M, Fernandez D, Restrepo A. Mucormycosis (zygomycosis) in a heart-kidney transplant recipient: recovery after posaconazole therapy. Clin Infect Dis 2003; 36: 1488-91.
192. Larkin JA, Montero JA. Efficacy and safety of amphotericin B lipid complex for zygomycosis. Infect Med 2003; 20: 201-6.
193. Deresinski SC, Stevens DA. Caspofungin. Clin Infect Dis 2003; 36: 1445-57.
194. Pandit SR, Raheem MA. Mucormycosis in acute myeloid leukaemia. Br J Haematol 2003; 121: 382.