Mucormycosis (cont.)

Treatments of mucormycosis need to be fast and aggressive. The need for speed is because by the time even the presumptive diagnosis is made, often the patient has suffered significant tissue damage that cannot be reversed. Most patients will require both surgical and medical treatments. Most infectious-disease experts say that without aggressive surgical debridement of the infected area, the patient is likely to die. Medications play an important role. Two main goals are sought at the same time: antifungal medications to slow or halt fungal spread and medications to treat any debilitating underlying diseases. Amphotericin B (initially intravenous) is the usual drug of choice for antifungal treatment. Patients with underlying diseases like diabetes need their diabetes optimally controlled. Patients normally on steroids or undergoing treatment with deferoxamine (Desferal; used to remove excess iron in the body) are likely to have these medications stopped because they can increase the survival of fungi in the body. Patients may need additional surgeries and usually need antifungal therapy for an extended time period (weeks to months) depending on the severity of the disease. Consultation with an infectious-disease expert is advised.

The complications of mucormycosis are serious and are related to the body area initially infected but also can occur in other body regions because the fungi often spreads to the organs or tissues that physically contact or are near the originally infected area. In addition, because surgical debridement is almost uniformly needed, some normal tissue may be destroyed because the surgeon must remove all tissue that is dead or dying. Unfortunately, that means the surgeon may have to remove some normal tissue to insure all of the fungi are removed. An example is infection of the eye orbit; often the whole eye must be removed. Consequently, serious complications such as blindness, meningitis, brain abscesses, osteomyelitis, pulmonary hemorrhages, gastrointestinal hemorrhages, cavitary lesions in organs and eventually secondary bacterial infections, sepsis, and death may occur.

Source: MedicineNet.com
http://www.medicinenet.com/mucormycosis/article.htm