Mucormycosis at a tertiary-care center in Mexico. A 35-year retrospective study of 214 cases.

Background Mucormycosis is a rare, invasive disease associated with high mortality rates, produced by opportunistic pathogens related to the Mucorales order, and characterized by a diverse range of clinical forms; acute rhino-orbital-cerebral and pulmonary symptoms are the most reported ones. Objectives To report the experience of mucormycosis observed in a tertiary-care hospital in Mexico for 35 years. Methods This was a retrospective, descriptive, and observational study on mucormycosis at a tertiary-care hospital in Mexico from January 1985 to December 2019. Demographic and clinical data, as well as mycological and histopathological records were selected. Results Two-hundred fourteen proven cases of mucormycosis for 35 years at a tertiary-care hospital in Mexico were included. Most of the cases were male patients with a median age of 45 years. The two most associated underlying diseases were diabetes mellitus (76.6%) and hematologic malignancy (15.4%). The three primary clinical forms were: rhino-orbito-cerebral (75.9%), cutaneous (8.41%), and pulmonary (7.47%) mucormycosis. The most isolated agents were Rhizopus arrhizus (58.4%), and Lichtheimia corymbifera (12.3%). The overall therapeutic response was 58.5%, and the best response was observed with amphotericin B deoxycholate and surgical debridement. Conclusion Mucormycosis is an emerging disease, and its incidence has increased at our hospital over the years. In this study, the rhino-cerebral clinical type was the most frequent in patients with uncontrolled diabetes; the main etiologic agent was R. arrhizus. Early diagnosis, control of the underlying disease, and prompt management may increase the survival rate.