Comparison of isolated respiratory and extrarespiratory mucormycosis: a 21-year observational study of 44 cases

Hyeonji Seo, Hyo Ju Son, Sungim Choi, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Joon Seon Song, Sang Oh Lee, Sang Ho Choi, Yang Soo Kim, Sung Han Kim

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: This study aimed to compare the clinical characteristics and outcomes of patients with isolated respiratory and extrarespiratory mucormycosis. Methods: Adult patients diagnosed with proven or probable invasive mucormycosis in a tertiary hospital in South Korea, between 1999 and 2020 were retrospectively reviewed. We compared the clinical, mycological characteristics, and outcomes of patients with isolated respiratory mucormycosis (IRM) and those with extrarespiratory mucormycosis (ERM). Results: A total of 44 patients including 32 (72%) with IRM, and 12 (27%) with ERM were enrolled. Of these, 38 (86%) were classified as proven and 6 (14%) as probable invasive mucormycosis according to the EORTC/MSG criteria. Univariate analysis exhibited that old age, surgery, and intensive care unit were associated with ERM, and multivariable analysis revealed that variable associated with ERM was intensive care unit (aOR 9.80; 95% CI 2.07–46.35; P = 0.004). There were no significant differences in 90-day mortality between patients with IRM and ERM (38% vs 50%, P = 0.45). In multivariable analysis, neutropenia (aOR 6.88; 95% CI 1.67–28.27; P = 0.01) was an independent risk factor for 90-day mortality. Conclusions: More than a quarter of patients with mucormycosis had extrarespiratory manifestations, especially in patients who were admitted to intensive care unit. The mortality of the patients with ERM was comparable to that of the patients with IRM, although the patients with ERM received ICU care more frequently.

Original languageEnglish
Pages (from-to)1313-1320
Number of pages8
JournalInfection
Volume50
Issue number5
DOIs
StatePublished - Oct 2022

Keywords

  • Central nervous system
  • Extrarespiratory
  • Gastrointestinal
  • Mortality
  • Mucormycosis

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