Abstract
Previously the term zygomycosis was used to refer to infections caused by fungi belonging to the phylum Zygomycota, class Zygomycetes, orders Mucorales and Entomophthorales. However, a more recent classification based on molecular phylogenetic studies of rRNA, tef1, and rpb1, has abolished the class Zygomycetes and instead distributes fungi previously in the phylum Zygomycota into the phylum Glomeromycota and four subphyla, including Mucoromycotina, Kickxellomycotina, Zoopagomycotina, and Entomophthoromycotina (Table 1) [1]. Therefore, the term zygomycosis, which has been used by clinicians and mycologists for decades, is no longer relevant to fungal taxonomy. Both terms, mucormycosis and zygomycosis, are used throughout this book, reflecting the recent changes in nomenclature and the slower evolution of clinical parlance.
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References
Hibbett DS, Binder M, Bischoff JF, et al. A higher-level phylogenetic classification of the Fungi. Mycol Res. 2007;111:509–47.
Ribes JA, Vanover-Sams CL, Baker DJ. Zygomycetes in human disease. Clin Microbiol Rev. 2000;13:236–301.
Sugar AM. Agents of Mucormycosis and Related Species. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 6th ed. Philadelphia: Elsevier; 2005. 2979.
Spellberg B, Edwards Jr J, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev. 2005;18:556–69.
Kwon-Chung KJ, Bennett JE. Mucormycosis. In: Medical mycology. Philadelphia: Lea & Febiger; 1992. p. 524–59.
Cohen-Abbo A, Bozeman PM, Patrick CC. Cunninghamella infections: review and report of two cases of Cunninghamella pneumonia in immunocompromised children. Clin Infect Dis. 1993;17:173–7.
Kontoyianis DP, Vartivarian S, Anaissie EJ, Samonis G, Bodey GP, Rinaldi M. Infections due to Cunninghamella bertholletiae in patients with cancer: report of three cases and review. Clin Infect Dis. 1994;18:925–8.
Kwon-Chung KJ, Young RC, Orlando M. Pulmonary mucormycosis caused by Cunninghamella elegans in a patient with chronic myelogenous leukemia. Am J Clin Pathol. 1975;64:544–8.
Motohashi K, Ito S, Hagihara M, Maruta A, Ishigatsubo Y, Kanamori H. Cutaneous zygomycosis caused by Cunninghamella bertholletiae in a patient with chronic myelogenous leukemia in blast crisis. Am J Hematol. 2009;84:447–8.
Bearer EA, Nelson PR, Chowers MY, Davis CE. Cutaneous zygomycosis caused by Saksenaea vasiformis in a diabetic patient. J Clin Microbiol. 1994;32:1823–4.
Lye GR, Wood G, Nimmo G. Subcutaneous zygomycosis due to Saksenaea vasiformis: rapid isolate identification using a modified sporulation technique. Pathology. 1996;28:364–5.
Pritchard RC, Muir DB, Archer KH, Beith JM. Subcutaneous zygomycosis due to Saksenaea vasiformis in an infant. Med J Australia. 1986;145:630–1.
Gonis G, Starr M. Fatal rhinoorbital mucormycosis caused by Saksenaea vasiformis in an immunocompromised child. Pediatr Infect Dis J. 1997;16:714–6.
Hay RJ, Campbell CK, Marshall WM, Rees BI, Pincott J. Disseminated zygomycosis (mucormycosis) caused by Saksenaea vasiformis. J Infect. 1983;7:162–5.
Torell J, Cooper BH, Helgeson NG. Disseminated Saksenaea vasiformis infection. Am J Clin Pathol. 1981;76:116–21.
Kemna ME, Neri RC, Ali R, Salkin IF. Cokeromyces recurvatus, a mucoraceous zygomycete rarely isolated in clinical laboratories. J Clin Microbiol. 1994;32:843–5.
Kamalam A, Thambiah AS. Cutaneous infection by Syncephalastrum. Sabouraudia. 1980;18:19–20.
Verweij PE, Voss A, Donnelly JP, de Pauw BE, Meis JF. Wooden sticks as the source of a pseudoepidemic of infection with Rhizopus microsporus var. rhizopodiformis among immunocompromised patients. J Clin Microbiol. 1997;35:2422–3.
Al-Asiri RH, Van Dijken PJ, Mahmood MA, Al-Shahed MS, Rossi ML, Osoba AO. Isolated hepatic mucormycosis in an immunocompetent child. Am J Gastroenterol. 1996;91:606–7.
Del Valle Zapico A, Rubio Suárez A, Mellado Encinas P, Morales Angulo C, Cabrera Pozuelo E. Mucormycosis of the sphenoid sinus in an otherwise healthy patient. Case report and literature review. J Laryngol Otol. 1996;110:471–3.
Petrikkos G, Skiada A, Sambatakou H, et al. Mucormycosis: ten-year experience at a tertiary-care center in Greece. Eur J Clin Microbiol Infect Dis. 2003;22:753–6.
O’Connell MA, Pluss JL, Schkade P, Henry AR, Goodman DL. Rhizopus-induced hypersensitivity pneumonitis in a tractor driver. J Allergy Clin Immunol. 1995;95:779–80.
Wimander K, Belin L. Recognition of allergic alveolitis in the trimming department of a Swedish sawmill. Eur J Respir Dis Suppl. 1980;107:163–7.
Marr KA, Carter RA, Crippa F, Wald A, Corey L. Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin Infect Dis. 2002;34:909–17.
Kontoyiannis DP, Wessel VC, Bodey GP, Rolston KV. Zygomycosis in the 1990s in a tertiary-care cancer center. Clin Infect Dis. 2000;30:851–6.
Maertens J, Demuynck H, Verbeken EK, et al. Mucormycosis in allogeneic bone marrow transplant recipients: report of five cases and review of the role of iron overload in the pathogenesis. Bone Marrow Transplant. 1999;24:307–12.
Marty FM, Cosimi LA, Baden LR. Breakthrough zygomycosis after voriconazole treatment in recipients of hematopoietic stem-cell transplants. N Engl J Med. 2004;350:950–2.
Greenberg RN, Scott LJ, Vaughn HH, Ribes JA. Zygomycosis (mucormycosis): emerging clinical importance and new treatments. Curr Opin Infect Dis. 2004;17:517–25.
Lueg EA, Ballagh RH, Forte V. Analysis of the recent cluster of invasive fungal sinusitis at the Toronto Hospital for Sick Children. J Otolaryngol. 1996;25:366–70.
Waldorf AR, Ruderman N, Diamond RD. Specific susceptibility to mucormycosis in murine diabetes and bronchoalveolar macrophage defense against Rhizopus. J Clin Invest. 1984;74:150–60.
Lamaris GA, Ben-Ami R, Lewis RE, Chamilos G, Samonis G, Kontoyiannis DP. Increased virulence of Zygomycetes organisms following exposure to voriconazole: a study involving fly and murine models of zygomycosis. J Infect Dis. 2009;199:1399–406.
Diamond RD, Krzesicki R, Epstein B, Jao W. Damage to hyphal forms of fungi by human leukocytes in vitro. A possible host defense mechanism in aspergillosis and mucormycosis. Am J Pathol. 1978;91:313–28.
Marx RS, Forsyth KR, Hentz SK. Mucorales species activation of a serum leukotactic factor. Infect Immun. 1982;38:1217–22.
Waldorf AR. Pulmonary defense mechanisms against opportunistic fungal pathogens. Immunol Ser. 1989;47:243–71.
Diamond RD, Haudenschild CC, Erickson NF. Monocyte-mediated damage to Rhizopus oryzae hyphae in vitro. Infect Immun. 1982;38:292–7.
Chinn RY, Diamond RD. Generation of chemotactic factors by Rhizopus oryzae in the presence and absence of serum: relationship to hyphal damage mediated by human neutrophils and effects of hyperglycemia and ketoacidosis. Infect Immun. 1982;38:1123–9.
Artis WM, Fountain JA, Delcher HK, Jones HE. A mechanism of susceptibility to mucormycosis in diabetic ketoacidosis: transferrin and iron availability. Diabetes. 1982;31:1109–14.
Boelaert JR, de Locht M, Van Cutsem J, et al. Mucormycosis during deferoxamine therapy is a siderophore-mediated infection. In vitro and in vivo animal studies. J Clin Invest. 1993;91:1979–86.
Howard DH. Acquisition, transport, and storage of iron by pathogenic fungi. Clin Microbiol Rev. 1999;12:394–404.
de Locht M, Boelaert JR, Schneider YJ. Iron uptake from ferrioxamine and from ferrirhizoferrin by germinating spores of Rhizopus microsporus. Biochem Pharmacol. 1994;47:1843–50.
Boelaert JR, Van Cutsem J, de Locht M, Schneider YJ, Crichton RR. Deferoxamine augments growth and pathogenicity of Rhizopus, while hydroxypyridinone chelators have no effect. Kidney Int. 1994;45:667–71.
Ibrahim AS, Spellberg B, Edwards Jr J. Iron acquisition: a novel perspective on mucormycosis pathogenesis and treatment. Curr Opin Infect Dis. 2008;21:620–5.
Ibrahim AS, Edwards JE, Jr, Fu Y, Spellberg B. Deferiprone iron chelation as a novel therapy for experimental mucormycosis. J Antimicrob Chemother. 2006;58:1070–3.
Ibrahim AS, Gebermariam T, Fu Y, et al. The iron chelator deferasirox protects mice from mucormycosis through iron starvation. J Clin Invest. 2007;117:2649–57.
Stearman R, Yuan DS, Yamaguchi-Iwai Y, Klausner RD, Dancis A. A permease-oxidase complex involved in high-affinity iron uptake in yeast. Science. 1996;271:1552–7.
Ibrahim AS, Gebermariam T, Lin L, Luo G, Husseiny MI, Skory CD, Fu Y, French SW, Edwards JE, Jr, Spellberg B. The high affinity iron permeasc is a key virulence factor required for Rhizopus oryzae pathogenesis. Mol Microbiol. 2010;77:587–604.
Santos R, Buisson N, Knight S, Dancis A, Camadro JM, Lesuisse E. Haemin uptake and use as an iron source by Candida albicans: role of CaHMX1-encoded haem oxygenase. Microbiology. 2003;149:579–88.
Worsham PL, Goldman WE. Quantitative plating of Histoplasma capsulatum without addition of conditioned medium or siderophores. J Med Vet Mycol. 1988;26:137–43.
Ma LJ, Ibrahim AS, Skory C, et al. Genomic analysis of the basal lineage fungus Rhizopus oryzae reveals a whole-genome duplication. PLoS Genet. 2009;5:e1000549.
Ibrahim AS, Edwards JE, Jr, Filler SG. Zygomycosis. In: Dismukes WE, Pappas PG, Sobel JD, editors. Clinical mycology. New York: Oxford University Press; 2003. p. 241–51.
Bouchara JP, Oumeziane NA, Lissitzky JC, Larcher G, Tronchin G, Chabasse D. Attachment of spores of the human pathogenic fungus Rhizopus oryzae to extracellular matrix components. Eur J Cell Biol. 1996;70:76–83.
Ibrahim AS, Spellberg B, Avanessian V, Fu Y, Edwards JE, Jr. Rhizopus oryzae adheres to, is phagocytosed by, and damages endothelial cells in vitro. Infect Immun. 2005;73:778–83.
Wang M, Wey S, Zhang Y, Ye R, Lee AS. Role of the unfolded protein response regulator GRP78/BiP in development, cancer and neurological disorders. Antioxidants Redox Signal. 2009;11:2307–16.
Ni M, Lee AS. ER chaperones in mammalian development and human diseases. FEBS Lett. 2007;581:3641–51.
Liu M, Spellberg B, Phan QT, Fu Y, Lec AS, Edwards JE Jr. Filler SG, Ibrahim AS. The endothelial cell receptor GRP78 is required for macormycosis pathogenesis in diabetic mice. J Clin Invest; 2010;120:1914–1924.
Jennessen J, Nielsen KF, Houbraken J, et al. Secondary metabolite and mycotoxin production by the Rhizopus microsporus group. J Agric Food Chem. 2005;53:1833–40.
Partida-Martinez LP, Hertweck C. Pathogenic fungus harbours endosymbiotic bacteria for toxin production. Nature. 2005;437:884–8.
Ibrahim AS, Gebremariam T, Liu M, et al. Bacterial endosymbiosis is widely present among zygomycetes but does not contribute to the pathogenesis of mucormycosis. J Infect Dis. 2008;198:1083–90.
Farley PC, Sullivan PA. The Rhizopus oryzae secreted aspartic proteinase gene family: an analysis of gene expression. Microbiology. 1998;144(Pt 8):2355–66.
Anand VK, Alemar G, Griswold Jr JA. Intracranial complications of mucormycosis: an experimental model and clinical review. Laryngoscope. 1992;102:656–62.
Pillsbury HC, Fischer ND. Rhinocerebral mucormycosis. Arch Otolaryngol. 1977;103:600–4.
McNulty JS. Rhinocerebral mucormycosis: predisposing factors. Laryngoscope. 1982;92:1140–3.
Peterson KL, Wang M, Canalis RF, Abemayor E. Rhinocerebral mucormycosis: evolution of the disease and treatment options. Laryngoscope. 1997;107:855–62.
Yanagisawa E, Friedman S, Kundargi RS, Smith HW. Rhinocerebral phycomycosis. Laryngoscope. 1977;87:1319–35.
Abedi E, Sismanis A, Choi K, Pastore P. Twenty-five years’ experience treating cerebro-rhino-orbital mucormycosis. Laryngoscope. 1984;94:1060–2.
Lowe Jr JT, Hudson WR. Rhincerebral phycomycosis and internal carotid artery thrombosis. Arch Otolaryngol. 1975;101:100–3.
LeCompte PM, Miessner WA. Mucormycosis of the central nervous system associated with hemochromatosis. Am J Pathol. 1947;23:673–6.
Bullock JD, Jampol LM, Fezza AJ. Two cases of orbital phycomycosis with recovery. Am J Ophthalmol. 1974;78:811–5.
Parfrey NA. Improved diagnosis and prognosis of mucormycosis. A clinicopathologic study of 33 cases. Medicine. 1986;65:113–23.
Blitzer A, Lawson W, Meyers BR, Biller HF. Patient survival factors in paranasal sinus mucormycosis. Laryngoscope. 1980;90:635–48.
Morrison VA, McGlave PB. Mucormycosis in the BMT population. Bone Marrow Transplant. 1993;11:383–8.
Rothstein RD, Simon GL. Subacute pulmonary mucormycosis. J Med Vet Mycol. 1986;24:391–4.
Tedder M, Spratt JA, Anstadt MP, Hegde SS, Tedder SD, Lowe JE. Pulmonary mucormycosis: results of medical and surgical therapy. Ann Thorac Surg. 1994;57:1044–50.
Harada M, Manabe T, Yamashita K, Okamoto N. Pulmonary mucormycosis with fatal massive hemoptysis. Acta Pathol Jpn. 1992;42:49–55.
Watts WJ. Bronchopleural fistula followed by massive fatal hemoptysis in a patient with pulmonary mucormycosis. A case report. Arch Intern Med. 1983;143:1029–30.
Gleissner B, Schilling A, Anagnostopolous I, Siehl I, Thiel E. Improved outcome of zygomycosis in patients with hematological diseases? Leuk Lymphoma. 2004;45:1351–60.
Kerr OA, Bong C, Wallis C, Tidman MJ. Primary cutaneous mucormycosis masquerading as pyoderma gangrenosum. Br J Dermatol. 2004;150:1212–3.
Gartenberg G, Bottone EJ, Keusch GT, Weitzman I. Hospital-acquired mucormycosis (Rhizopus rhizopodiformis) of skin and subcutaneous tissue: epidemiology, mycology and treatment. N Engl J Med. 1978;299:1115–8.
Mead JH, Lupton GP, Dillavou CL, Odom RB. Cutaneous Rhizopus infection. Occurrence as a postoperative complication associated with an elasticized adhesive dressing. J Am Med Assoc. 1979;242:272–4.
Ledgard JP, van Hal S, Greenwood JE. Primary cutaneous zygomycosis in a burns patient: a review. J Burn Care Res. 2008;29:286–90.
Boyd AS, Wiser B, Sams HH, King LE. Gangrenous cutaneous mucormycosis in a child with a solid organ transplant: a case report and review of the literature. Pediatr Dermatol. 2003;20:411–5.
Kordy FN, Al-Mohsen IZ, Hashem F, Almodovar E, Al Hajjar S, Walsh TJ. Successful treatment of a child with posttraumatic necrotizing fasciitis caused by Apophysomyces elegans: case report and review of literature. Pediatr Infect Dis J. 2004;23:877–9.
Prasad RM, Bose SM, Vaiphei K, Verma GR. Post operative abdominal wall mucormycosis mimicking as bacterial necrotising fasciitis. J Postgrad Med. 2003;49:187–8.
Amin SB, Ryan RM, Metlay LA, Watson WJ. Absidia corymbifera infections in neonates. Clin Infect Dis. 1998;26:990–2.
Sharma MC, Gill SS, Kashyap S, et al. Gastrointestinal mucormycosis–an uncommon isolated mucormycosis. Indian J Gastroenterol. 1998;17:131–3.
Straatsma BR, Zimmerman LE, Gass JDM. Phycomycosis: a clinicopathologic study of fifty-one cases. Lab Invest. 1962;11:963–85.
Woods KF, Hanna BJ. Brain stem mucormycosis in a narcotic addict with eventual recovery. Am J Med. 1986;80:126–8.
Virmani R, Connor DH, McAllister HA. Cardiac mucormycosis. A report of five patients and review of 14 previously reported cases. Am J Clin Pathol. 1982;78:42–7.
Tuder RM. Myocardial infarct in disseminated mucormycosis: case report with special emphasis on the pathogenic mechanisms. Mycopathologia. 1985;89:81–8.
Vesa J, Bielsa O, Arango O, Lladó C, Gelabert A. Massive renal infarction due to mucormycosis in an AIDS patient. Infection. 1992;20:234–6.
Maliwan N, Reyes CV, Rippon JW. Osteomyelitis secondary to cutaneous mucormycosis. Report of a case and a review of the literature. Am J Dermatopathol. 1984;6:479–81.
Pierce PF, Wood MB, Roberts GD, Fitzgerald Jr RH, Robertson C, Edson RS. Saksenaea vasiformis osteomyelitis. J Clin Microbiol. 1987;25:933–5.
Leong ASY. Granulomatous mediastinitis due to Rhizopus species. Am J Clin Pathol. 1978;70:103–7.
Connor BA, Anderson RJ, Smith JW. Mucor mediastinitis. Chest. 1979;75:524–6.
Andrews DR, Allan A, Larbalestier RI. Tracheal mucormycosis. Ann Thorac Surg. 1997;63:230–2.
Helenglass G, Elliott JA, Lucie NP. An unusual presentation of opportunistic mucormycosis. Br Med J (Clin Res ed). 1981;282:108–9.
Ogunlana EO. Fungal air spora at Ibadan, Nigeria. Appl Microbiol. 1975;29:458–63.
Mori T, Egashira M, Kawamata N, et al. Zygomycosis: two case reports and review of reported cases in the literature in Japan. Nippon Ishinkin Gakkai Zasshi. 2003;44:163–79.
Tietz HJ, Brehmer D, Jänisch W, Martin H. Incidence of endomycoses in the autopsy material of the Berlin Charité Hospital. Mycoses. 1998;41 Suppl 2:81–5.
Reed C, Bryant R, Ibrahim AS, et al. Combination polyene-caspofungin treatment of rhino-orbital-cerebral mucormycosis. Clin Infect Dis. 2008;47:364–71.
Chamilos G, Marom EM, Lewis RE, Lionakis MS, Kontoyiannis DP. Predictors of pulmonary zygomycosis versus invasive pulmonary aspergillosis in patients with cancer. Clin Infect Dis. 2005;41:60–6.
Wahba H, Truong MT, Lei X, Kontoyiannis DP, Marom EM. Reversed halo sign in invasive pulmonary fungal infections. Clin Infect Dis. 2008;46:1733–7.
Chamilos G, Lewis RE, Kontoyiannis DP. Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin Infect Dis. 2008;47:503–9.
Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005;41:634–53.
Walsh TJ, Finberg RW, Arndt C, et al. Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutropenia. National Institute of Allergy and Infectious Diseases Mycoses Study Group. N Engl J Med. 1999;340:764–71.
Walsh TJ, Hiemenz JW, Seibel NL, et al. Amphotericin B lipid complex for invasive fungal infections: analysis of safety and efficacy in 556 cases. Clin Infect Dis. 1998;26:1383–96.
Ibrahim AS, Avanessian V, Spellberg B, Edwards Jr JE. Liposomal amphotericin B, and not amphotericin B deoxycholate, improves survival of diabetic mice infected with Rhizopus oryzae. Antimicrob Agents Chemother. 2003;47:3343–4.
Groll AH, Giri N, Petraitis V, et al. Comparative efficacy and distribution of lipid formulations of amphotericin B in experimental Candida albicans infection of the central nervous system. J Infect Dis. 2000;182:274–82.
Ibrahim AS, Gebremariam T, Husseiny MI, et al. Comparison of lipid amphotericin B preparations in treating murine zygomycosis. Antimicrob Agents Chemother. 2008;52:1573–6.
Sun QN, Fothergill AW, McCarthy DI, Rinaldi MG, Graybill JR. In vitro activities of posaconazole, itraconazole, voriconazole, amphotericin B, and fluconazole against 37 clinical isolates of zygomycetes. Antimicrob Agents Chemother. 2002;46:1581–2.
Blin N, Morineau N, Gaillard F, et al. Disseminated mucormycosis associated with invasive pulmonary aspergillosis in a patient treated for post-transplant high-grade non-Hodgkin’s lymphoma. Leuk Lymphoma. 2004;45:2161–3.
Imhof A, Balajee SA, Fredricks DN, Englund JA, Marr KA. Breakthrough fungal infections in stem cell transplant recipients receiving voriconazole. Clin Infect Dis. 2004;39:743–6.
Kobayashi K, Kami M, Murashige N, Kishi Y, Fujisaki G, Mitamura T. Breakthrough zygomycosis during voriconazole treatment for invasive aspergillosis. Haematologica 2004;89:ECR42.
Kontoyiannis DP, Lionakis MS, Lewis RE, et al. Zygomycosis in a tertiary-care cancer center in the era of Aspergillus-active antifungal therapy: a case-control observational study of 27 recent cases. J Infect Dis. 2005;191:1350–60.
Oren I. Breakthrough zygomycosis during empirical voriconazole therapy in febrile patients with neutropenia. Clin Infect Dis. 2005;40:770–1.
Pfaller MA, Messer SA, Hollis RJ, Jones RN. Antifungal activities of posaconazole, ravuconazole, and voriconazole compared to those of itraconazole and amphotericin B against 239 clinical isolates of Aspergillus spp. and other filamentous fungi: report from SENTRY Antimicrobial Surveillance Program, 2000. Antimicrob Agents Chemother. 2002;46:1032–7.
Lass-Florl C, Mayr A, Perkhofer S, et al. Activities of antifungal agents against yeasts and filamentous fungi: assessment according to the methodology of the European Committee on Antimicrobial Susceptibility Testing. Antimicrob Agents Chemother. 2008;52:3637–41.
Arikan S, Sancak B, Alp S, Hascelik G, McNicholas P. Comparative in vitro activities of posaconazole, voriconazole, itraconazole, and amphotericin B against Aspergillus and Rhizopus, and synergy testing for Rhizopus. Med Mycol. 2008;12:1–7.
Ullmann AJ, Cornely OA, Burchardt A, et al. Pharmacokinetics, safety, and efficacy of posaconazole in patients with persistent febrile neutropenia or refractory invasive fungal infection. Antimicrob Agents Chemother. 2006;50:658–66.
Krishna G, Martinho M, Chandrasekar P, Ullmann AJ, Patino H. Pharmacokinetics of oral posaconazole in allogeneic hematopoietic stem cell transplant recipients with graft-versus-host disease. Pharmacotherapy. 2007;27:1627–36.
Krishna G, Parsons A, Kantesaria B, Mant T. Evaluation of the pharmacokinetics of posaconazole and rifabutin following co-administration to healthy men. Curr Med Res Opin. 2007;23:545–52.
Krishna G, Sansone-Parsons A, Martinho M, Kantesaria B, Pedicone L. Posaconazole plasma concentrations in juvenile patients with invasive fungal infection. Antimicrob Agents Chemother. 2007;51:812–8.
Sun QN, Najvar LK, Bocanegra R, Loebenberg D, Graybill JR. In vivo activity of posaconazole against Mucor spp. in an immunosuppressed-mouse model. Antimicrob Agents Chemother. 2002;46:2310–2.
Dannaoui E, Meis JF, Loebenberg D, Verweij PE. Activity of posaconazole in treatment of experimental disseminated zygomycosis. Antimicrob Agents Chemother. 2003;47:3647–50.
Ibrahim AS, Gebremariam T, Schwartz JA, Edwards Jr JE, Spellberg B. Posaconazole mono- or combination therapy for treatment of murine zygomycosis. Antimicrob Agents Chemother. 2009;53:772–5.
Rodriguez MM, Serena C, Marine M, Pastor FJ, Guarro J. Posaconazole combined with amphotericin B, an effective therapy for a murine-disseminated infection caused by Rhizopus oryzae. Antimicrob Agents Chemother. 2008;52:3786–8.
van Burik JA, Hare RS, Solomon HF, Corrado ML, Kontoyiannis DP. Posaconazole is effective as salvage therapy in zygomycosis: a retrospective summary of 91 cases. Clin Infect Dis. 2006;42:e61–5.
Greenberg RN, Mullane K, van Burik JA, et al. Posaconazole as salvage therapy for zygomycosis. Antimicrob Agents Chemother. 2006;50:126–33.
Diekema DJ, Messer SA, Hollis RJ, Jones RN, Pfaller MA. Activities of caspofungin, itraconazole, posaconazole, ravuconazole, voriconazole, and amphotericin B against 448 recent clinical isolates of filamentous fungi. J Clin Microbiol. 2003;41:3623–6.
Espinel-Ingroff A. In vitro antifungal activities of anidulafungin and micafungin, licensed agents and the investigational triazole posaconazole as determined by NCCLS methods for 12, 052 fungal isolates: review of the literature. Rev Iberoam Micol. 2003;20:121–36.
Ibrahim AS, Bowman JC, Avanessian V, et al. Caspofungin inhibits Rhizopus oryzae 1, 3-beta-D-glucan synthase, lowers burden in brain measured by quantitative PCR, and improves survival at a low but not a high dose during murine disseminated zygomycosis. Antimicrob Agents Chemother. 2005;49:721–7.
Spellberg B, Fu Y, Edwards Jr JE, Ibrahim AS. Combination therapy with amphotericin B lipid complex and caspofungin acetate of disseminated zygomycosis in diabetic ketoacidotic mice. Antimicrob Agents Chemother. 2005;49:830–2.
Ibrahim AS, Gebremariam T, Fu Y, Edwards Jr JE, Spellberg B. Combination echinocandin-polyene treatment of murine mucormycosis. Antimicrob Agents Chemother. 2008;52:1556–8.
Lamaris GA, Lewis RE, Chamilos G, et al. Caspofungin-Mediated beta-Glucan Unmasking and Enhancement of Human Polymorphonuclear Neutrophil Activity against Aspergillus and Non-Aspergillus Hyphae. J Infect Dis. 2008;198:186–92.
Cappellini MD. Iron-chelating therapy with the new oral agent ICL670 (Exjade). Best Pract Res Clin Haematol. 2005;18:289–98.
Ibrahim AS, Gebermariam T, Fu Y, et al. The iron chelator deferasirox protects mice from mucormycosis through iron starvation. J Clin Invest. 2007;117:2649–57.
Piga A, Galanello R, Forni GL, et al. Randomized phase II trial of deferasirox (Exjade, ICL670), a once-daily, orally-administered iron chelator, in comparison to deferoxamine in thalassemia patients with transfusional iron overload. Haematologica. 2006;91:873–80.
Miyazawa K, Ohyashiki K, Urabe A, et al. A safety, pharmacokinetic and pharmacodynamic investigation of deferasirox (Exjade, ICL670) in patients with transfusion-dependent anemias and iron-overload: a Phase I study in Japan. Int J Hematol. 2008;88:73–81.
Reed C, Ibrahim A, Edwards Jr JE, Walot I, Spellberg B. Deferasirox, an iron-chelating agent, as salvage therapy for rhinocerebral mucormycosis. Antimicrob Agents Chemother. 2006;50:3968–9.
Spellberg B, Andes D, Perez M, et al. Safety and outcomes of open-label deferasirox iron chelation therapy for mucormycosis. Antimicrob Agents Chemother. 2009;53:3122–5.
Soummer A, Mathonnet A, Scatton O, et al. Failure of deferasirox, an iron chelator agent, combined with antifungals in a case of severe zygomycosis. Antimicrob Agents Chemother. 2008;52:1585–6.
Couch L, Theilen F, Mader JT. Rhinocerebral mucormycosis with cerebral extension successfully treated with adjunctive hyperbaric oxygen therapy. Arch Otolaryngol Head Neck Surg. 1988;114:791–4.
Robb SM. Reactions of fungi to exposure to 10 atmospheres pressure of oxygen. J Gen Microbiol. 1966;45:17–29.
Gil-Lamaignere C, Simitsopoulou M, Roilides E, Maloukou A, Winn RM, Walsh TJ. Interferon- gamma and Granulocyte-Macrophage Colony-Stimulating Factor Augment the Activity of Polymorphonuclear Leukocytes against Medically Important Zygomycetes. J Infect Dis. 2005;191:1180–7.
Abzug MJ, Walsh TJ. Interferon-gamma and colony-stimulating factors as adjuvant therapy for refractory fungal infections in children. Pediatr Infect Dis J. 2004;23:769–73.
Gonzalez CE, Couriel DR, Walsh TJ. Disseminated zygomycosis in a neutropenic patient: successful treatment with amphotericin B lipid complex and granulocyte colony-stimulating factor. Clin Infect Dis. 1997;24:192–6.
Kullberg BJ, Anaissie EJ. Cytokines as therapy for opportunistic fungal infections. Res Immunol. 1998;149:478–88. discussion 515.
Ma B, Seymour JF, Januszewicz H, Slavin MA. Cure of pulmonary Rhizomucor pusillus infection in a patient with hairy-cell leukemia: role of liposomal amphotericin B and GM-CSF. Leuk Lymphoma. 2001;42:1393–9.
Mastroianni A. Paranasal sinus mucormycosis in an immunocompetent host: efficacy and safety of combination therapy with Liposomal Amphotericin B and adjuvant rHuGM-CSF. Infez Med. 2004;12:278–83.
Grigull L, Beilken A, Schmid H, et al. Secondary prophylaxis of invasive fungal infections with combination antifungal therapy and G-CSF-mobilized granulocyte transfusions in three children with hematological malignancies. Support Care Cancer. 2006;14:783–6.
Slavin MA, Kannan K, Buchanan MR, Sasadeusz J, Roberts AW. Successful allogeneic stem cell transplant after invasive pulmonary zygomycosis. Leuk Lymphoma. 2002;43:437–9.
Thakar A, Baruah P, Kumar S, Sharma MC. Rhinophycomycosis. J Laryngol Otol. 2001;115:493–6.
Yang X, Li Y, Zhou X, et al. Rhinofacial conidiobolomycosis caused by Conidiobolus coronatus in a Chinese rice farmer. Mycoses. 2010;53(4):369–73.
Gugnani HC. Entomophthoromycosis due to Conidiobolus. Eur J Epidemiol. 1992;8:391–6.
Martinson FD. Chronic phycomycosis of the upper respiratory tract. Rhinophycomycosis entomophthorae. Am J Trop Med Hyg. 1971;20:449–55.
Dworzack DL, Pollock AS, Hodges GR, Barnes WG, Ajello L, Padhye A. Zygomycosis of the maxillary sinus and palate caused by Basidiobolus haptosporus. Arch Intern Med. 1978;138:1274–6.
Walsh TJ, Renshaw G, Andrews J, et al. Invasive zygomycosis due to Conidiobolus incongruus. Clin Infect Dis. 1994;19:423–30.
Tan DC, Hsu LY, Koh LP, Goh YT, Koh M. Severe conidiobolomycosis complicating induction chemotherapy in a patient with acute lymphoblastic leukaemia. Br J Haematol. 2005;129:447.
Okafor JI, Testrake D, Mushinsky HR, Yangco BG. A Basidiobolus sp. and its association with reptiles and amphibians in southern Florida. Sabouraudia. 1984;22:47–51.
Rippon JW. Medical mycology. 2nd ed. Philadelphia: The W.B. Saunders Company; 1982. p. 303–14.
Dreschler C. Two new species of Conidiobolus found in the plant detritus. Am J Bot. 1960;47:368–77.
Costa AR, Porto E, Pegas JR, et al. Rhinofacial zygomycosis caused by Conidiobolus coronatus. A case report. Mycopathologia. 1991;115:1–8.
Cameroon HM. Entomophthoromycosis. In: Mahgoub ES, editor. Tropical mycoses. Beerse: Janssen Research Council; 1990. p. 186–98.
Dreschler C. Supplementary development stages of Basidiobolus ranarum and Basidiobolus haptosporus. Mycologia. 1956;48:655–77.
Goodman NL, Rinaldi MG. Agents of zygomycosis. In: Balows A, Hausler WJ, Herrmann KL, Isenberg HD, Shadomy HJ, editors. Manual of clinical microbiology. 5th ed. Washington: ASM Press; 1991. p. 674–92.
Bittencourt AL, Arruda SM, de Andrade JA, Carvalho EM. Basidiobolomycosis: a case report. Pediatr Dermatol. 1991;8:325–8.
Chandler FW, Watts JC. Pathologic diagnosis of fungal infections. Chicago: ASCP Press; 1987. p. 85–95.
Kamalam A, Thambiah AS. Muscle invasion by Basidiobolus haptosporus. Sabouraudia. 1984;22:273–7.
van den Berk GE, Noorduyn LA, van Ketel RJ, van Leeuwen J, Bemelman WA, Prins JM. A fatal pseudo-tumour: disseminated basidiobolomycosis. BMC Infect Dis. 2006;6:140.
Pasha TM, Leighton JA, Smilack JD, Heppell J, Colby TV, Kaufman L. Basidiobolomycosis: an unusual fungal infection mimicking inflammatory bowel disease. Gastroenterology. 1997;112:250–4.
Al Jarie A, Al-Mohsen I, Al Jumaah S, et al. Pediatric gastrointestinal basidiobolomycosis. Pediatr Infect Dis J. 2003;22:1007–14.
Hussein MR, Musalam AO, Assiry MH, Eid RA, El Motawa AM, Gamel AM. Histological and ultrastructural features of gastrointestinal basidiobolomycosis. Mycol Res. 2007;111:926–30.
Bigliazzi C, Poletti V, Dell’Amore D, Saragoni L, Colby TV. Disseminated basidiobolomycosis in an immunocompetent woman. J Clin Microbiol. 2004;42:1367–9.
Singh R, Xess I, Ramavat AS, Arora R. Basidiobolomycosis: a rare case report. Indian J Med Microbiol. 2008;26:265–7.
Onuigbo WI, Gugnani HC, Okafor BC, Misch KA. Nasal entomophthorosis in an Igbo from Nigeria. J Laryngol Otol. 1975;89:657–61.
Ravisse P, Destombes P, Le Gonidec G. 10 new clinical cases of mycoses caused by Entomophorales in Cameroon. Bull Soc Pathol Exot Filiales. 1976;69:33–40.
Bittencourt AL, Serra G, Sadigursky M, Araujo MG, Campos MC, Sampaio LC. Subcutaneous zygomycosis caused by Basidiobolus haptosporus: presentation of a case mimicking Burkitt’s lymphoma. Am J Trop Med Hyg. 1982;31:370–3.
Okafor BC, Gugnani HC, Jacob A. Nasal entomophthorosis with laryngeal involvement. Mykosen. 1983;26:471–7.
Drouhet E, Dupont B. Laboratory and clinical assessment of ketoconazole in deep-seated mycoses. Am J Med. 1983;74:30–47.
Restrepo A. Treatment of tropical mycoses. J Am Acad Dermatol. 1994;31:S91–102.
Barro-Traore F, Ouedraogo D, Konsem T, et al. Conidiobolomycosis, a rare fungal tumor: a case report in Ouagadougou, Burkina Faso. Bull Soc Pathol Exot. 2008;101:14–6.
Mathew R, Kumaravel S, Kuruvilla S, et al. Successful treatment of extensive basidiobolomycosis with oral itraconazole in a child. Int J Dermatol. 2005;44:572–5.
Yangco BG, Okafor JI, TeStrake D. In vitro susceptibilities of human and wild-type isolates of Basidiobolus and Conidiobolus species. Antimicrob Agents Chemother. 1984;25:413–6.
Mukhopadhyay D, Ghosh LM, Thammayya A, Sanyal M. Entomophthoromycosis caused by Conidiobolus coronatus: clinicomycological study of a case. Auris Nasus Larynx. 1995;22:139–42.
Foss NT, Rocha MR, Lima VT, Velludo MA, Roselino AM. Entomophthoramycosis: therapeutic success by using amphotericin B and terbinafine. Dermatology. 1996;193:258–60.
Fischer N, Ruef C, Ebnother C, Bachli EB. Rhinofacial Conidiobolus coronatus infection presenting with nasal enlargement. Infection. 2008;36:594–6.
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Ibrahim, A.S., Edwards, J.E., Filler, S.G., Spellberg, B. (2011). Mucormycosis and Entomophthoramycosis (Zygomycosis). In: Kauffman, C., Pappas, P., Sobel, J., Dismukes, W. (eds) Essentials of Clinical Mycology. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6640-7_15
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