Skin-nontumor / Clinical Dermatology - Fungi

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Infectious disorders

Fungi - Zygomycosis

Reviewer: Nat Pernick, M.D., PathologyOutlines.com, Inc. (see Reviewers page)
Revised: 20 July 2011, last major update July 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Clinical features
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● Infections caused by fungi in class Zygomycetes, including Absidia, Mucor, Rhizomucor, Rhizopus, Apophysomyces elegans (rare human pathogen)
● Most zygomycosis occur in immunocompromised patients (due to leukemia, lymphoma, diabetes, transplantation), with rhinocerebral or pulmonary infection, then dissemination
● Other causes include iron overload, major trauma, chronic corticosteroids, intravenous drug use / injection abscess (Indian J Med Res 2010;131:765), neonatal prematurity, malnourishment
● A. elegans causes progressive necrosis of wound in previously healthy patients after trauma or invasive procedures (Arch Pathol Lab Med 1999;123:386)

Diagnosis
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● PCR or culture
● A. elegans - grows as a rapidly growing mold with sporangiophores having dark brown, funnel shaped apophyses and pyriform sporangia

Treatment
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● Treat underlying medical condition, reduce immunosuppression, correct metabolic abnormalities (Mediterr J Hematol Infect Dis 2011;3:e2011012)
● Amphotericin B or newer drugs
● Surgical debridement

Clinical images
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Rhizomucor culture has "cotton candy" like texture, grows rapidly, maturation within 4 days

Rhizomucor culture demonstrates sparsely septate broad hyphae, irregularly branched sporangiophores, brown round sporangia, rhizoids located on stolons between sporangiophores

Micro description
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● Extensive coagulative necrosis due to fungi with broad, sparsely septate, thin-walled hyphae
● Angioinvasion with thrombosis

Micro images
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Aseptate hyphae

Mucor infection

PAS stain

Additional references
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● The University of Adelaide

End of Skin-nontumor / Clinical Dermatology > Infectious disorders > Fungi - Zygomycosis

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