Abstract
Background
Mucormycosis is a rare, life-threatening invasive fungal disease that mostly affects immunocompromised hosts. the objectives of this study to assess clinical presentations and outcomes among patients with mucormycosis in a tertiary care hospital, western Saudi Arabia.
Methods
A retrospective chart review of cases diagnosed with mucormycosis was conducted from January 2009 to December 2019 in King Abdulaziz Medical City, Jeddah, in the western region of Saudi Arabia. Data were obtained on demographic information, comorbidities including immunocompromised conditions
Results
16 cases were identified as proven or probable mucormycosis according to revised European organization for research and treatment of cancer/mycoses study group criteria (EORTC/MSGERC). Most cases (n=11, 68.75%) were categorized as proven while 5 cases (31.25 %) as probable. The median age of cases 29.5 years, with 5 cases were less than 18 years. Cutaneous mucormycosis is the predominant presentation as noted in 7 cases (43.75%), followed by rhino-orbital-cerebral mucormycosis in 4 cases (25%), and pulmonary mucormycosis in 2 cases (12.5). Rhizopus and mucor species were the two main fungal isolates. The most common underlying etiology were hematological malignancies (n=7, 43.75%) , trauma with a motor vehicle accident( n=4 ,25%) , and diabetes mellitus(n=4 ,25%) . Most of the patients treated with amphotericin B lipid complex alone or in combination with posaconazole. The average days of antifungal use were 57.2 days. Most patients (n=11, 68.75%) undergone either one or repeated surgical debridement. Overall, 11 (68.75%) patients died, 2 of them prior to a confirmed diagnosis. All pulmonary cases died, the majority (75%) of rhino-orbital-cerebral, and 57.1% of the cutaneous cases died as well.
Conclusion
Mortality among cases with mucormycosis was high. Relatively better survival was observed among the cutaneous cases. A combination of new diagnostic technologies, optimized use of available antifungal options, development of new antifungal agents, and consistent implementation of public health policies may help to reduce mortality rates from mucormycosis in Saudi Arabia.
Disclosures
All Authors: No reported disclosures
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