Table 1 Demographic and clinical characteristics of adultand children patients with confirmed mucormycosis (n = 164).
Total (N = 164) | Children (N = 38) | Adults (N = 126) | p-value | |
|---|---|---|---|---|
Gender | ||||
Male | 91 (55.5%) | 27 (71.1%) | 64 (50.8%) | 0.04 |
Female | 73 (44.5%) | 11 (28.9%) | 62 (49.2%) | |
Seasonal distribution | ||||
Spring | 26 (15.9%) | 9 (23.7%) | 17 (13.5%) | 0.14 |
Summer | 48 (29.3%) | 10 (26.3%) | 38 (30.2%) | |
Autumn | 52 (31.7%) | 11 (28.9%) | 41 (32.5%) | |
Winter | 38 (23.2%) | 8 (21.1%) | 30 (23.8%) | |
Cases per year | ||||
2013–2014 | 20 (12.2%) | 1 (2.6%) | 19 (15.1%) | 0.53 |
2014–2015 | 15 (9.1%) | 4 (10.5%) | 11 (8.7%) | |
2015–2016 | 13 (7.9%) | 1 (2.6%) | 12 (9.5%) | |
2016–2017 | 22 (13.4%) | 7 (18.4%) | 15 (11.9%) | |
2017–2018 | 19 (11.6%) | 5 (13.2%) | 14 (11.1%) | |
2018–2019 | 33 (20.1%) | 12 (31.6%) | 21 (16.7%) | |
2019–2020 | 27 (16.5%) | 6 (15.8%) | 21 (16.7%) | |
2020–2021 | 15 (9.1%) | 2 (5.3%) | 13 (10.3%) | |
Site of infection | ||||
Rhino-orbito-cerebral | 158 (96.4%) | 37 (97.4%) | 121 (96%) | 0.61 |
Pulmonary | 2 (1.2%) | 1 (2.6%) | 1 (0.8%) | |
Gastrointestinal | 1 (0.6%) | – | 1 (0.8%) | |
Rare forms† | 3 (1.8%) | – | 3 (2.4%) | |
Predisposing risk factors | ||||
Hematological malignancies | 62 (37.8%) | 18 (47.4%) | 44 (34.9%) | < 0.001 |
AML | 35 | 5 | 30 | |
ALL | 17 | 9 | 8 | |
CLL | 6 | 0 | 6 | |
Non-Hodgkin lymphoma | 4 | 4 | 0 | |
Diabetes mellitus | 61 (37.2%) | 3 (7.9%) | 58 (46.0 %) | |
Iatrogenic trauma | 5 (3.0%) | 1 (2.6%) | 4 (3.2%) | |
Chronic Corticosteroid use | 5 (3.0%) | – | 5 (4.0%) | |
Solid organ transplantation | 4 (2.4%) | – | 4 (3.2%) | |
Chemotherapy | 1 (0.6%) | – | 1 (0.8%) | |
OtherPredisposing factor‡ | 7 (4.3%) | 3 (7.9%) | 4 (3.2%) | |
Immunocompetent patients | 18 (11.0%) | 11 (28.9%) | 7 (5.6%) | |
Clinical manifestation | ||||
Pain and swelling of the eye | 45 (27.4%) | 15 (39.5%) | 30 (23.8%) | 0.60 |
Bloody nasal discharge with obstruction in the nasal cavities | 30 (18.3%) | 6 (15.8%) | 24 (19.0%) | |
Headache | 28 (17.1%) | 7 (18.4%) | 21 (16.7%) | |
Swelling and facial pain | 26 (15.9%) | 3 (7.9%) | 23 (18.3%) | |
Decreased level of consciousness | 14 (8.5%) | 2 (5.3%) | 12 (9.5%) | |
Fever | 9 (5.5%) | 2 (5.3%) | 7 (5.6%) | |
Nasal cavity and septum ulcer | 5 (3.0%) | 1 (2.6%) | 4 (3.2%) | |
Hard palate ulcer | 4 (2.4%) | 1 (2.6%) | 3 (2.4%) | |
Facial/ abducens nerve palsy | 3 (1.8%) | – | 3 (2.4%) | |
Cough and shortness of breath | 2 (1.2%) | 1 (2.6%) | 1 (0.8%) | |
Abdominal pain | 1 (0.6%) | – | 1 (0.8%) | |
Treatment | ||||
LAMB§ | 141 (86.0%) | 35 (92.1%) | 106 (84.2%) | 0.05 |
LAMB and posaconazole | 7 (4.2%) | 3 (7.9%) | 4 (3.1%) | |
LAMB with other triazoles | 10 (6.1%) | – | 10 (8.0%) | |
LAMB with azole and caspofungin | 6 (3.7%) | – | 6 (4.7%) | |
Outcome | ||||
Survival | 136 (82.9%) | 38 (100%) | 98 (77.8%) | < 0.001 |
Mortality | 24 (14.6%) | – | 24 (19.0%) | |
Discharge with personal consent | 4 (2.4%) | – | 4 (3.2%) | |
