ABSTRACT
Mucorales species exhibit cenocytic hyphae, although septa delimiting reproductive structures can be visualized in several taxa, as well as irregularly spaced septa, which can be observed in aged colonies. This chapter summarizes the knowledge about predisposing factors, pathogenesis, clinical presentation, diagnosis, and treatment of mucormycosis. Laboratory diagnosis is indispensable to prescribe adequate treatment for a favourable clinical outcome, since mucormycosis is often fatal when undiagnosed and/or not treated early. The therapeutic strategies against mucormycosis include antifungal therapy, surgery, and reduction of immunosuppression. Aggressive surgical debridement associated with anti-mucormycosis drugs like amphotericin B/posaconazole is a better choice than antifungal therapy alone. Mucoralean fungi have a strong tropism for arteries and penetrate the internal elastic lamina, promoting endothelial damage, thrombosis, and infarction. Inhalation of sporangiospores—the Mucorales fungal spores—which are present in the environment, is the principle mode of acquisition and colonization of the spores in the nasal/sinus mucosa.
