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

Autor: Salehi M; Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran., Mahmoudi S; Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran., Rezahosseini O; Viro-immunology Research Unit, Department of Infectious Disease, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Hashemi SJ; Department of Medical Parasitology and Mycology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran., Ahmadikia K; Department of Medical Parasitology and Mycology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran., Aala F; Department of Parasitology and Mycology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran., Khajavirad N; Internal Medicine Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran., Alijani N; Department of Infectious Diseases, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran., Izadi A; Department of Medical Parasitology and Mycology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran., Getso MI; Department of Medical Parasitology and Mycology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.; Department of Medical Microbiology and Parasitology, College of Health Sciences, Bayero University, Kano, Nigeria., Abdollahi A; Department of Pathology, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran., Salami A; Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran., Khatami SR; Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran., Adibimehr A; Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran., Hedayat Yaghoobi M; Department of Infectious Diseases, Alborz University of Medical Sciences, Karaj, Iran., Sabahi M; Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran., Pazooki B; Internal Medicine Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran., Yazdi F; Department of Infectious Diseases, Arak social Security Organization Hospital, Arak, Iran., Zebardast J; Neurocognitive Science Special Linguistics, Institute for Cognitive Science Studies, Tehran, Iran., Saifi A; Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran., Hasan Nezhad M; Department of Infectious Diseases and Tropical Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran., Mardani M; Infectious Disease and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Khodavaisy S; Department of Medical Parasitology and Mycology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Jazyk: angličtina
Zdroj: Iranian journal of pathology [Iran J Pathol] 2022 Spring; Vol. 17 (2), pp. 112-121. Date of Electronic Publication: 2022 Mar 08.
DOI: 10.30699/IJP.2022.538690.2721
Abstrakt: 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.
Competing Interests: OR received a grant from the Research Foundation of Rigshospitalet related, and a grant from A.P. MØLLER FONDEN not related to this work. The authors declare that they have no competing interests.
Databáze: MEDLINE
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