Zygomycosis in the 1990s in a tertiary-care cancer center

Clin Infect Dis. 2000 Jun;30(6):851-6. doi: 10.1086/313803. Epub 2000 Jun 13.


Twenty-four patients with cancer met predetermined criteria for a diagnosis of zygomycosis over a 10-year period at our institution. All had hematologic malignancy, and most had either neutropenia or steroid use as a risk factor. Pulmonary involvement mimicking invasive aspergillosis was the most common presentation, and dissemination was seen in 58% of patients on whom autopsies were performed. Three-fourths of the patients with pulmonary zygomycosis had pathogenic microorganisms other than zygomycetes isolated from respiratory specimens. The sensitivity of cultures in detecting zygomycetes from respiratory specimens was low. A culture positive for zygomycetes was typically a preterminal finding in the fatal, acute cases. Two-thirds of the patients died. Favorable outcome seemed to correlate with lack of pulmonary involvement, surgical debridement, neutrophil recovery, and a cumulative total amphotericin B dose of 2000 mg. Therapy with high-dose amphotericin B, combined with aggressive surgery and immune reconstitution, offers the best chance for survival of cancer patients with zygomycosis.

MeSH terms

  • Cancer Care Facilities*
  • Female
  • Hematologic Neoplasms / complications*
  • Humans
  • Lung Diseases, Fungal / epidemiology*
  • Lung Diseases, Fungal / microbiology
  • Male
  • Mucorales / classification
  • Mucorales / isolation & purification*
  • Mucormycosis / epidemiology*
  • Mucormycosis / microbiology
  • Retrospective Studies
  • Risk Factors