What are the risk factors for mucormycosis (zygomycosis)?

Updated: Jul 06, 2021
  • Author: Avnish Sandhu, DO; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Immunocompromising conditions are the main risk factors for mucormycosis. Patients with uncontrolled diabetes mellitus, especially those with ketoacidosis, are at high risk. Other high-risk groups include patients with cancer, especially those who are neutropenic and those receiving broad-spectrum antibiotics, and individuals receiving immunosuppressive agents, including oral or intravenous steroids and tumor necrosis factor (TNF)-alpha blockers (patients with rheumatoid disorders). In addition, patients with hematologic cancer who have opportunistic cytomegalovirus infections and graft versus host disease (GVHD) are at an increased risk. Prior receipt of voriconazole is another risk factor for mucormycosis. [3]

Extreme malnutrition is also linked to mucormycosis, especially the gastrointestinal (GI) form. Iron is a growth stimulant for Mucorales; older iron chelators such as deferoxamine and all causes of iron overload are additional risk factors for mucormycosis. Trauma and the use of contaminated medical supplies over wounds are associated with cutaneous mucormycosis. Additionally, nonsterile tape and contaminated wooden splints are other risk factors for cutaneous diseases. [4, 5]  Such cases are associated with trauma/surgery or the presence of a preexisting wound or intravascular line. Patients with burns and those who use intravenous drugs are at a higher risk.

Some patients with mucormycosis have no identifiable risk factors. [6, 7] Invasive mucormycosis has also been associated with health-care associated outbreaks and natural disasters. [8, 9, 10, 11, 12]


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