Which tests are performed in the workup of mucormycosis (zygomycosis)?

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

Timely diagnosis is paramount in cases of mucormycosis. [63]  Diagnosis of mucormycosis requires positive culture and histopathological changes. However, there are certain instances where culture may not be available or results may be negative; in such instances, diagnosis is made by histopathology alone. [64]  

Patients with suspected or confirmed mucormycosis should be treated as a medical emergency; they should be referred to institutions that can perform highest level of care. [39]  The European Confederation Medical Mycology (ECMM) society lays out a diagnostic approach based on symptoms and underlying risk factors [39] :

  • Among patients with respiratory symptoms (fever, cough) who are neutropenic, chest computed tomography (CT) should be obtained; CT guided biopsy or bronchoalveolar lavage (BAL) with biopsy should be obtained and the specimen should be sent for histopathology, culture with susceptibility testing and molecular identification with PCR, and multiplex target (18s, ITS, 28s, or ribosomal DNA). [39]
  • Among patients with facial pain, sinusitis, and underlying diabetes, cranial CT or magnetic resonance imaging should be obtained, followed by biopsy; the specimen should be sent for: histopathology (GMS and PAS stain), culture with susceptibility testing and molecular identification with PCR testing, multiplex target (18s, ITS, 28s, or ribosomal DNA). [39]
  • Among patients presenting with history of trauma and cutaneous manifestation, biopsy of the lesion (escher) should be obtained and sent for histopathology, culture with susceptibility testing and molecular identification with PCR testing, multiplex target (18s, ITS, 28s, or ribosomal DNA). [39]

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