CLINICAL MICROBIOLOGY REVIEWS, Apr. 2011, p. 411–445 Vol. 24, No. 2 0893-8512/11/$12.00 doi:10.1128/CMR.00056-10 Copyright © 2011, American Society for Microbiology. All Rights Reserved. Mucormycosis Caused by Unusual Mucormycetes, Non-Rhizopus,-Mucor, and -Lichtheimia Species Marisa Z. R. Gomes,1,2 Russell E. Lewis,1,3 and Dimitrios P. Kontoyiannis1* Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 770301; Nosocomial Infection Research Laboratory, Instituto Oswaldo Cruz, Fundac¸a˜o Oswaldo Cruz, Rio de Janeiro, Brazil2; and University of Houston College of Pharmacy, Houston, Texas3 INTRODUCTION .......................................................................................................................................................412 TAXONOMIC ORGANIZATION OF UNUSUAL MUCORALES ORGANISMS.............................................412 Downloaded from LITERATURE SEARCH AND CRITERIA .............................................................................................................413 Cunninghamella bertholletiae...................................................................................................................................414 Taxonomy.............................................................................................................................................................414 Reported cases.....................................................................................................................................................414 Epidemiology and risk factors ..........................................................................................................................415 Pathogenesis ........................................................................................................................................................416 Clinical presentation ..........................................................................................................................................417 (i) Disseminated infection .............................................................................................................................417 (ii) Pulmonary infection.................................................................................................................................418 http://cmr.asm.org/ (iii) Cardiovascular involvement ..................................................................................................................418 (iv) Rhino-orbito-cerebral infection .............................................................................................................418 (v) Soft tissue infection..................................................................................................................................419 (vi) Peritonitis .................................................................................................................................................419 (vii) Breakthrough C. bertholletiae infection................................................................................................419 (viii) C. bertholletiae infection in pediatric patients ...................................................................................419 (ix) Chronic infection.....................................................................................................................................419 Diagnosis..............................................................................................................................................................419 Management ........................................................................................................................................................420 Rhizomucor pusillus .................................................................................................................................................421 on November 15, 2018 by guest Taxonomy.............................................................................................................................................................421 Reported cases.....................................................................................................................................................422 Epidemiology .......................................................................................................................................................422 Pathogenesis ........................................................................................................................................................423 Clinical presentation ..........................................................................................................................................423 (i) Pulmonary infection..................................................................................................................................423 (ii) Disseminated infection ............................................................................................................................423 (iii) Soft tissue infections and osteomyelitis...............................................................................................423 (iv) Rhino-orbito-cerebral infection .............................................................................................................424 (v) Cerebral infection .....................................................................................................................................424 (vi) Intra-abdominal infection ......................................................................................................................424 (vii) Chronic and recurrent infections.........................................................................................................424 (viii) Breakthrough infections.......................................................................................................................424 Diagnosis..............................................................................................................................................................424 Management and prognosis ..............................................................................................................................424 Apophysomyces elegans Complex ............................................................................................................................425 Taxonomy.............................................................................................................................................................425 Reported cases and epidemiology.....................................................................................................................425 Pathogenesis ........................................................................................................................................................425 Clinical presentation ..........................................................................................................................................426 (i) Soft tissue infection and osteomyelitis ...................................................................................................426 (ii) Rhino-orbito-cerebral infection..............................................................................................................426 (iii) Disseminated infection...........................................................................................................................426 (iv) Renal infection.........................................................................................................................................427 (v) Intra-abdominal infection........................................................................................................................427 (vi) Subacute or chronic infection................................................................................................................427 * Corresponding author. Mailing address: Department of Infectious Diseases, Infection Control and Employee Health, Unit 1460, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030. Phone: (713) 792-6237. Fax: (713) 745-6839. E-mail: [email protected]. 411 412 GOMES ET AL. CLIN.MICROBIOL.REV. Diagnosis..............................................................................................................................................................427 Management ........................................................................................................................................................427 Prognosis..............................................................................................................................................................428 Saksenaea vasiformis complex ................................................................................................................................428 Taxonomy and reported cases...........................................................................................................................428 Epidemiology .......................................................................................................................................................428 Pathogenesis ........................................................................................................................................................428