3. Zygomycosis is the fungal disease which is caused by,
Mucorales
Entomophthorales
These are bread mold fungi, belong to ,
Phylum Zygomycota
Family Mucoraceas
Group Mucormycetes
Order Mucoracease
These fungi ( spores) are present throughout the environment.
( Vegetables, Soil, Water, Decaying, leaves).
These spores are inhaled by the individuals which caused infection .
Primary infected the Lung.
Also caused dissemination infection if enter into the blood stream, which
commonly affect the lungs, GIT and Skin.
caused infection in immunocompromised patients, AIDs and cancer patients,
Childs and the most who exposure to the spores of the fungi.
INTRODUCTION
4. It also caused disseminated infection if entered into the blood stream
spreads which affect the lungs and brain and, in the worst cases, cause
pneumonia, infection of the brain, seizures, paralysis, and death.
This infection is diagnosed with laboratory tests examining nasal
discharges and phlegm, as well as by conducting biopsies of, for
example, lung lesions.
Treatment includes surgical removal of the infected tissue, if possible,
and use of medicines such as high-dose amphotericin B.
These fungi live throughout the environment, particularly in soil and in
association with decaying organic matter, such as leaves, compost piles,
or rotten wood.
The disease is not passed person to person.
INTRODUCTION…
5. Mainly caused by these two species
Mucorales and
Entomophthorales
Other Species are
Rhizopus species
Mucor species
Cunninghamella bertholletiae
Apophysomyces species
and Lichtheimia species.
ETIOLOGY
6. Zygomycosis can affect nearly any parts of the body, but it
most commonly affects the sinuses or the lungs in people
who having weakened immune systems.
Rhinocerebral (sinus and brain) zygomycosis:
It is an infection in the sinuses that can spread to the brain.
This form of zygomycosis is most common in people with
uncontrolled diabetes.
Pulmonary (lung) zygomycosis:
It is the most common type of zygomycosis in people with
cancer and in people who have had an organ transplant or a
stem cell transplant.
TYPES OF ZYGOMYCOSIS
7. Gastrointestinal zygomycosis:
This can result from ingestion of the fungal spores. This type of
zygomycosis is less common among adults and is more common
among young children, especially infants <1 month of age.
Cutaneous (skin) zygomycosis:
This occurs after the fungi enter the body through a break in the skin
(for example, after surgery, a burn, or other type of skin trauma).
This is the most common form of zygomycosis among people who
do not have weakened immune systems.
Disseminated zygomycosis :
This occurs when the infection spreads through the bloodstream to
affect another part of the body. The brain is the most commonly
affected part of the body, but other organs such as the spleen, heart,
and skin can also be affected.
TYPES …
8. The symptoms of zygomycosis depend on where in the body
the fungus is growing. Zygomycosis is rare and typically affects
people with weakened immune systems.
pulmonary (lung) zygomycosis
Chest pain
Cough
Coughing blood (occasionally)
Fever
Disseminated zygomycosis
Typically occurs in people who are already sick from other
medical conditions, so it can be difficult to know which
symptoms are related to zygomycosis. Patients with
disseminated infection in the brain can develop mental
status changes or coma.
SYMPTOMS OF ZYGOMYCOSIS
9. Abdominal pain
Blood in the stools
Diarrhea
Vomiting blood
Blisters or ulcers
The infected area may
turn black
Pain
Warmth
Excessive redness
Swelling around a wound.
Gastrointestinal
mucormycosis
Cutaneous (skin)
zygomycosis
SYMPTOMS OF ZYGOMYCOSIS
10. Dark scabbing in nasal cavities
Mental status changes
Redness of skin above sinuses
Sinus pain or congestion
One-sided facial swelling
Eyes that swell and stick out (protrude)
Headache
Black lesions on upper inside of mouth
Fever
SYMPTOMS OF RHINOCEREBRAL
(SINUS AND BRAIN) ZYGOMYCOSIS
11. Inhalation of spores is the most common mode of entry.
The spores then germinate to produce hyphae, which invade
blood vessels, causing thrombosis and subsequent tissue necrosis.
Invasion of the vessels also promotes dissemination of the fungus
to other organs.
Normal mononuclear and polymorpho nuclear phagocytes are
essential to kill Mucorales by generating oxidative metabolites
and cationic peptide defensins.
Macrophages inhibit spore germination and neutrophils damage
hyphae.
Various factors increase the risk of acquiring mucormycosis by
impairing either quantity of neutrophils, as in chemotherapy-
induced neutropenia, or quality of neutrophils, as with
corticosteroids and acidosis.
PATHOGENESIS
12. Diabetes, especially with diabetic ketoacidosis
Cancer
Organ transplant
Stem cell transplant
Neutropenia (low number of white blood cells)
Long-term corticosteroid use
Skin trauma (due to surgery, burns, or other skin injuries)
AIDS
Diabetes (usually poorly controlled)
Leukemia and lymphoma
Long-term steroid use
Poor nutrition (malnutrition)
RISK FACTORS
13. People get zygomycosis by coming in contact with fungal
spores in the environment.
For example, the lung or sinus forms of the infection can
occur after someone inhales the spores from the air.
Zygomycosis can develop on the skin after the fungus enters
the skin through a cut, scrape, burn, or other type of skin
trauma.
Is zygomycosis contagious?
No. Zygomycosis can’t spread between people or between
people and animals.
TRANSMISSION
14. International
The distribution of the various forms of zygomycosis is uniform regardless
of age, geography, or race.
Mortality/Morbidity
The overall mortality rate associated with zygomycosis is approximately
50% and has remained at this level for the past 50 years.
Rhinocerebral zygomycosis carries a mortality rate of approximately 85%.
Mortality rates are very high because, by the time zygomycosis is suspected
and diagnosed, it has frequently spread diffusely and caused extensive
tissue destruction.
However, the risk of mortality varies depending on the characteristics of
the host, the type of infection, the site of infection, and the use of surgical
intervention.
Sex
According to the latest epidemiologic surveys, approximately two thirds of
all zygomycosis cases occur in males.
EPIDEMIOLOGY
15. Medical history, symptoms, physical examinations,
and laboratory tests
•Specimens:
Aspirated material from sinuses
Sputum in pulmonary disease
Biopsy material
DIAGNOSIS
16. The following steps are used for the both types of
Zygomycosis
10 or 20% KOH
Typically contain thick-walled aseptate hyphae
Swollen cells (up to 50 um) and distorted hyphae may
be present
Culture
SDA without cycloheximide at 30°C
Rapid growth
A diagnosis can also be made
by examining a biopsy for granuloma formation and the
presence of aseptate hyphae, eosinophils, neutrophils,
and fibroblasts.
Tissue for culture should be send in a dry sterile
container, and biopsies should be fixed and send in
formal saline.
24. Zygomycosis is a serious infection and needs to be treated
with prescription antifungal medication, usually
amphotericin B, posaconazole or isavuconazole.
Through a intravenous (amphotericin B, posaconazole,
isavuconazole)
by mouth (posaconazole, isavuconazole).
Often, zygomycosis requires surgery to cut away the
infected tissue.
Prevention
Because the fungi that cause mucormycosis are widespread,
the best way to prevent this infection is to improve control
of the illnesses associated with mucormycosis.
TREATMENT
