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Delay in diagnosis increases mortality in Mucormycosis

December 21 2015

Mucormycosis was once considered a rare disease, but is now reported at a high rate in India, China and Brazil. Dr Jeong and colleagues from Seoul, South Korea reported that delayed diagnostic procedure (>16 days after onset of symptoms) was an independent predictor for mortality. This mirrors previous work from the MD Anderson Cancer Centre in Houston where delayed amphotericin B therapy (≥6 days) resulted in two-fold increase in mortality rate at 12 weeks after diagnosis. Article

The disease is more common in uncontrolled diabetics in India and China, and has been reported in 1.6 cases/1000 diabetics. Once infection sets in, it spreads rapidly through the blood vessels causing necrosis and damage of vital organs leading to death unless the disease is aggressively managed by surgical debridement and amphotericin B therapy. Mucormycosis is a ‘Fungal Emergency’ due its rapid spread. Despite improved recognition in recent years, mortality rate of this disease still ranges from 40 to 100%.

Adding to the complexity of the problem, current diagnostic procedures are insensitive and slow. Microscopy and histology remain the key diagnostic tools, with culture infrequently positive. Contrary to other invasive fungal infections, there is little progress in molecular diagnosis of mucormycosis. Further awareness, better diagnostic mycology laboratories and development of molecular diagnostic techniques are urgently required for mucormycos.

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