Zygomycosis

Zygomycosis is the broadest term to refer to infections caused by bread mold fungi of the zygomycota phylum. However, because zygomycota has been identified as polyphyletic, and is not included in modern fungal classification systems, the diseases that zygomycosis can refer to are better called by their specific names: mucormycosis[1] (after Mucorales), phycomycosis[2] (after Phycomycetes) and basidiobolomycosis (after Basidiobolus).[3] These rare yet serious and potentially life-threatening fungal infections usually affect the face or oropharyngeal (nose and mouth) cavity.[4] Zygomycosis type infections are most often caused by common fungi found in soil and decaying vegetation. While most individuals are exposed to the fungi on a regular basis, those with immune disorders (immunocompromised) are more prone to fungal infection.[2][5][6] These types of infections are also common after natural disasters, such as tornadoes or earthquakes, where people have open wounds that have become filled with soil or vegetative matter.[7]

Mucormycosis
Periorbital fungal infection known as mucormycosis, or phycomycosis
SpecialtyInfectious disease 

The condition may affect the gastrointestinal tract or the skin. In non-trauma cases, it usually begins in the nose and paranasal sinuses and is one of the most rapidly spreading fungal infections in humans.[2] Common symptoms include thrombosis and tissue necrosis.[8] Treatment consists of prompt and intensive antifungal drug therapy and surgery to remove the infected tissue.[9][10] The prognosis varies vastly depending upon an individual patient's circumstances.[8]

Causes

Micrograph showing a zygomycetes infection.

Pathogenic zygomycosis is caused by species in two orders: Mucorales or Entomophthorales, with the former causing far more disease than the latter.[11] These diseases are known as "mucormycosis" and "entomophthoramycosis", respectively.[12]

  • Order Mucorales (mucormycosis)
    • Family Mucoraceae
      • Absidia (Absidia corymbifera)
      • Apophysomyces (Apophysomyces elegans and Apophysomyces trapeziformis)
      • Mucor (Mucor indicus)
      • Rhizomucor (Rhizomucor pusillus)
      • Rhizopus (Rhizopus oryzae)
    • Family Cunninghamellaceae
      • Cunninghamella (Cunninghamella bertholletiae)
    • Family Thamnidiaceae
      • Cokeromyces (Cokeromyces recurvatus)
    • Family Saksenaeaceae
      • Saksenaea (Saksenaea vasiformis)
    • Family Syncephalastraceae
      • Syncephalastrum (Syncephalastrum racemosum)
  • Order Entomophthorales (entomophthoramycosis)
    • Family Basidiobolaceae
      • Basidiobolus (Basidiobolus ranarum)
    • Family Ancylistaceae
      • Conidiobolus (Conidiobolus coronatus/Conidiobolus incongruus)

Epidemiology

Zygomycosis has been found in survivors of the 2004 Indian Ocean earthquake and tsunami and in survivors of the 2011 Joplin, Missouri tornado.[13]

Other animals

The term oomycosis is used to describe oomycete infections.[14] These are more common in animals, notably dogs and horses. These are heterokonts, not true fungi. Types include pythiosis (caused by Pythium insidiosum) and lagenidiosis.

Zygomycosis has been described in a cat, where fungal infection of the tracheobronchus led to respiratory disease requiring euthanasia.[15]

References

  1. Toro, Carlos; del Palacio, Amalia; Álvarez, Carmen; Rodríguez-Peralto, José Luis; Carabias, Esperanza; Cuétara, Soledad; Carpintero, Yolanda; Gómez, César (1998). "Zigomicosis cutánea por Rhizopus arrhizus en herida quirúrgica" [Cutaneous zygomycosis caused by Rhizopus arrhizus in a surgical wound]. Revista Iberoamericana de Micología (in Spanish). 15 (2): 94–6. PMID 17655419.
  2. Auluck, Ajit (2007). "Maxillary necrosis by mucormycosis. a case report and literature review" (PDF). Medicina Oral Patologia Oral y Cirugia Bucal. 12 (5): E360–4. PMID 17767099.
  3. Centers for Disease Control and Prevention (1999). "Gastrointestinal Basidiobolomycosis — Arizona, 1994–1999". Morbidity and Mortality Weekly Report. 48 (32): 710–3. PMID 21033182.
  4. Nancy F Crum-Cianflone; MD MPH. "Mucormycosis". eMedicine. Retrieved 19 May 2008.
  5. "MedlinePlus Medical Encyclopedia: Mucormycosis". Retrieved 19 May 2008.
  6. Ettinger, Stephen J.; Feldman, Edward C. (1995). Textbook of Veterinary Internal Medicine (4th ed.). W.B. Saunders Company. ISBN 0-7216-6795-3.
  7. Draper, Bill; Suhr, Jim (11 June 2011). "Survivors of Joplin tornado develop rare infection". Seattle Post-Intelligencer. Associated Press.
  8. Spellberg, B.; Edwards, J.; Ibrahim, A. (2005). "Novel Perspectives on Mucormycosis: Pathophysiology, Presentation, and Management". Clinical Microbiology Reviews. 18 (3): 556–69. doi:10.1128/CMR.18.3.556-569.2005. PMC 1195964. PMID 16020690.
  9. Spellberg, Brad; Walsh, Thomas J.; Kontoyiannis, Dimitrios P.; Edwards, Jr.; Ibrahim, Ashraf S. (2009). "Recent Advances in the Management of Mucormycosis: From Bench to Bedside". Clinical Infectious Diseases. 48 (12): 1743–51. doi:10.1086/599105. PMC 2809216. PMID 19435437.
  10. Grooters, A (2003). "Pythiosis, lagenidiosis, and zygomycosis in small animals". Veterinary Clinics of North America: Small Animal Practice. 33 (4): 695–720. doi:10.1016/S0195-5616(03)00034-2. PMID 12910739.
  11. Ribes, J. A.; Vanover-Sams, C. L.; Baker, D. J. (2000). "Zygomycetes in Human Disease". Clinical Microbiology Reviews. 13 (2): 236–301. doi:10.1128/CMR.13.2.236. PMC 100153. PMID 10756000.
  12. Prabhu, R. M.; Patel, R. (2004). "Mucormycosis and entomophthoramycosis: A review of the clinical manifestations, diagnosis and treatment". Clinical Microbiology and Infection. 10: 31–47. doi:10.1111/j.1470-9465.2004.00843.x. PMID 14748801.
  13. "Joplin toll rises to 151; some suffer from fungus". Associated Press. 10 June 2011 via Medical Xpress.
  14. "Merck Veterinary Manual". Retrieved 4 April 2009.
  15. Snyder, Katherine D.; Spaulding, Kathy; Edwards, John (2010). "Imaging diagnosis—tracheobronchial zygomycosis in a cat". Veterinary Radiology & Ultrasound. 51 (6): 617–20. doi:10.1111/j.1740-8261.2010.01720.x. PMID 21158233.
Classification
External resources

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