Pulmonary mucormycosis: Perspectives on diagnosis and therapy

Mucormycosis refers to the spectrum of disease caused by Zygomycetes. Host risk factors include hematological malignancy, solid organ transplant, diabetes mellitus, chronic metabolic acidosis, and corticosteroid and deferoxamine use. The clinical and radiographic features of pulmonary mucormycosis are nonspecific. Common presenting symptoms include fever, cough, dyspnea, and pleuritic chest pain. Bronchoscopy with biopsy and subsequent tissue culture can yield a definitive diagnosis. Treatment modalities include surgical excision and debridement when feasible, intravenous amphotericin B and, potentially, posaconazole. Despite aggressive therapy, the mortality rate associated with pulmonary mucormycosis remains high. Control of predisposing factors appears to be a promising strategy in decreasing mortality.