Repository of Research and Investigative Information

Repository of Research and Investigative Information

Kurdistan University of Medical Sciences

The Epidemiological, Clinical, Mycological, and Pathological Features of Rhino-cerebral Mucormycosis: A Systematic Review

(2022) The Epidemiological, Clinical, Mycological, and Pathological Features of Rhino-cerebral Mucormycosis: A Systematic Review. Iranian journal of pathology.

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Official URL: https://www.ncbi.nlm.nih.gov/pubmed/35463720

Abstract

Cerebral mucormycosis (CM) is a life-threatening manifestation of mucormycosis, an angioinvasive fungal infection caused by Mucorales. We sought to systematically review all available case reports to describe epidemiologic features, clinical manifestations, predisposing factors, and diagnostic and treatment strategies of CM. A systematic search was conducted using a combination of the following keywords: "Mucor", "Zygomycetes", "mucormycosis", "cereb*", "brain", "central nervous system", and "intracranial", separately and in combination until December 31(st) 2018. Data sources included PubMed, Scopus, EMBASE, Web of Science, Science Direct, and Proquest without limiting the time of publication. We included 287 articles corresponding to 345 cases of CM. Out of the 345 cases, 206 (60) were male with a median age of 44 years; 130 (38) were reported from North America; 87 (25) from Asia; and 84 (24) from Europe. The median time from onset of symptoms to presentation was 3-7 days (65/345, 65). The highest mortality was observed among patients with diabetes mellitus (P=0.003). Debridement of infected brain tissue was associated with improved survival in CM cases (OR 1.5; 95 CI 01.3-1.8; P<0.0001). The use of liposomal amphotericin B (L-AMB) was significantly associated with patients' recovery (OR 2.09; 95 CI 1.2-3.4; P=0.003). The combination of L-AMB and posaconazole (12.5) was more effective than the monotherapy treatment of CM cases (P=0.009). Clinicians should consider DM as an important risk factor for CM. Moreover, surgical debridement and antifungal combination therapy could be an effective approach in the management of CM patients.

Item Type: Article
Keywords: Cerebral mucormycosis Diabetes mellitus Invasive fungal infections grant from A.P. MOLLER FONDEN not related to this work. The authors declare that they have no competing interests.
Page Range: pp. 112-121
Journal or Publication Title: Iranian journal of pathology
Volume: 17
Number: 2
Depositing User: مهندس مهدی شریفی
URI: http://eprints.muk.ac.ir/id/eprint/5574

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