14 : Zygomycosis

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Zygomycosis, Page 1 of 2

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There is now accumulating evidence that receipt of prophylaxis or treatment with voriconazole and the severity of the immunosuppression appear to work in conjunction to favor increase in the incidence of zygomycosis in hematopoietic stem cell transplantation (HSCT) recipients. This increase in zygomycosis stands in contrast to prior reports of breakthrough infections seen when fluconazole or itraconazole was used for antifungal prophylaxis in HSCT recipients. The importance of iron availability in the pathogenesis of zygomycosis is underscored by the increased incidence of zygomycosis in patients on deferoxamine therapy or with iron overload. Sinus disease is estimated that about two-thirds of the cases of sinus zygomycosis occur in diabetic patients, often in the presence of diabetic ketoacidosis. Opacification of the paranasal sinuses, fluid levels, bone destruction, and osteomyelitis are the main radiographic findings associated with sinus zygomycosis. Among the different sites, primary pulmonary infection is more frequently associated with disseminated zygomycosis. The presenting signs, symptoms, and radiographic findings of zygomycosis are nonspecific and should be interpreted with respect to the underlying condition of the patient. Despite the recent advances in antifungal therapy, zygomycosis continues to be one of the most fulminant mycoses in humans. Correction of the patient’s underlying condition that predisposes to zygomycosis is one of the cornerstones of successful management of this devastating infection. Surgical debridement is of critical importance for the successful management of zygomycosis. Zygomycetes cause disease in a number of susceptible hosts with different predisposing conditions, including surgery, burns, trauma, diabetes mellitus, and treatment with deferoxamine.

Citation: Gonzalez C, Antachopoulos C, Walsh T, Shoham S. 2007. Zygomycosis, p 247-281. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch14
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Image of Figure 1.
Figure 1.

Rhinocerebral zygomycosis, demonstrating left ethmoidal infection, disruption of the lamina papyracea, invasion of the orbital compartment, proptosis of the globe of the eye, sphenoidal sinusitis, cavernous sinus involvement, and a cerebellar pontine infarct.

Citation: Gonzalez C, Antachopoulos C, Walsh T, Shoham S. 2007. Zygomycosis, p 247-281. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch14
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Image of Figure 2.
Figure 2.

Pulmonary zygomycosis. The CT image demonstrates early pulmonary zygomycosis involving the left lower lobe, with multiple small nodular infiltrates, including a larger peripheral subpleural nodule surrounded by a delicate alveolar infiltrate.

Citation: Gonzalez C, Antachopoulos C, Walsh T, Shoham S. 2007. Zygomycosis, p 247-281. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch14
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Image of Figure 3.
Figure 3.

Histological characteristics of invasive zygomycosis. The isolate of in this excisional biopsy specimen of the kidney demonstrates broad, ribbon-like, sparsely septated hyphae with nondichotomous “right-angled” branching.

Citation: Gonzalez C, Antachopoulos C, Walsh T, Shoham S. 2007. Zygomycosis, p 247-281. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch14
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Image of Figure 4.
Figure 4.

Photomicrographs of three medically important genera of Zygomycetes: (top), (middle), and (bottom). (Top) The rhizoids, or root-like structures, of the genus arise from the base of the connection between the sporangiophores and stolon. The sporangia in this photomicrograph have opened to release their contents of sporangiospores (original magnification, ×200). (Middle) The genus is characterized by the absence of rhizoids at the junction between the sporangiophores and stolon. The curved sporangiophores in this photomicrograph are typical of (original magnification, ×400). (Bottom) The sporangium of is distinct in having sporangioles on the surface of the sporangium (original magnification, ×630). Sporangioles of spp. are connected to the sporangium by short processes known as ostioles.

Citation: Gonzalez C, Antachopoulos C, Walsh T, Shoham S. 2007. Zygomycosis, p 247-281. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch14
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Image of Figure 5.
Figure 5.

Therapeutic approach to zygomycosis.

Citation: Gonzalez C, Antachopoulos C, Walsh T, Shoham S. 2007. Zygomycosis, p 247-281. In Scheld W, Hooper D, Hughes J (ed), Emerging Infections 7. ASM Press, Washington, DC. doi: 10.1128/9781555815585.ch14
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1. Abedi, E.,, A. Sismanis,, K. Choi, and, P. Pastore. 1984. Twenty-five years’ experience treating cerebro-rhino-orbital mucormycosis. Laryngoscope 94:10601062.
2. Abzug, M. J., and, T. J. Walsh. 2004. Interferon-gamma and colony-stimulating factors as adjuvant therapy for refractory fungal infections in children. Pediatr. Infect. Dis. J. 23:769773.
3. Adler, D. E.,, T. H. Milhorat, and, J. I. Miller. 1998. Treatment of rhinocerebral mucormycosis with intravenous interstitial, and cerebrospinal fluid administration of amphotericin B: case report. Neurosurgery 42:644649.
4. Adriaenssens, K.,, P. G. Jorens,, L. Meuleman,, W. Jeuris, and, J. Lambert. 2000. A black necrotic skin lesion in an immunocompromised patient. Diagnosis: cutaneous mucormycosis. Arch. Dermatol. 136:11651170.
5. Agh, F.,, S. Spanik,, J. Gyarfas,, J. Horvath, and, V. Krcmery, Jr., 1992. Three fatal cases of disseminated mucormycosis associated with respiratory distress syndrome and shock in patients with hematologic malignancies. Infection 20:112.
6. Ajello, L.,, D. F. Dean, and, R. S. Irwin. 1976. The zygomycete Saksenaea vasiformis as a pathogen of humans with a critical rewiew of the etiology of zygomycosis. Mycologia 68:5262.
7. al-Abbadi, M. A.,, K. Russo, and, E. J. Wilkinson. 1997. Pulmonary mucormycosis diagnosed by bronchoalveolar lavage: a case report and review of the literature. Pediatr. Pulmonol. 23:222225.
8. Amin, S. B.,, R. M. Ryan,, L. A. Metlay, and, W. J. Watson. 1998. Absidia corymbifera infections in neonates. Clin. Infect. Dis. 26:990992.
9. Anaissie, E. J., and, A. H. Shikhani. 1985. Rhinocerebral mucormycosis with internal carotid occlusion: report of two cases and review of the literature. Laryngoscope 95:11071113.
10. Anand, V. K.,, G. Alemar, and, J. A. Griswold, Jr., 1992. Intracranial complications of mucormycosis: an experimental model and clinical review. Laryngoscope 102:656662.
11. Andrews, D. R.,, A. Allan, and, R. I. Larbalestier. 1997. Tracheal mucormycosis. Ann. Thorac. Surg. 63:230232.
12. Antachopoulos, C., and, E. Roilides. 2005. Cytokines and fungal infections. Br. J. Haematol. 129:583596.
13. Antman, K. S.,, J. D. Griffin,, A. Elias,, M. A. Socinski,, L. Ryan,, S. A. Cannistra,, D. Oette,, M. Whitley,, E. Frei III, and, L. E. Schnipper. 1988. Effect of recombinant human granulocyte-macrophage colony-stimulating factor on chemotherapy-induced myelosuppression. N. Engl. J. Med. 319:593598.
14. Arisoy, A. E.,, E. S. Arisoy,, A. Correa-Calderon, and, S. L. Kaplan. 1993. Rhizopus necrotizing cellulitis in a preterm infant: a case report and review of the literature. Pediatr. Infect. Dis. J. 12:10291031.
15. Artis, W. M.,, J. A. Fountain,, H. K. Delcher, and, H. E. Jones. 1982. A mechanism of susceptibility to mucormycosis in diabetic ketoacidosis: transferrin and iron availability. Diabetes 31:11091114.
16. Atkinson, J. B.,, D. H. Connor,, M. Robinowitz,, H. A. McAllister, and, R. Virmani. 1984. Cardiac fungal infections: review of autopsy findings in 60 patients. Hum. Pathol. 15:935942.
17. Bagdade, J. D., 1976. Phagocytic and microbicidal function in diabetes mellitus. Acta Endocrinol. Suppl. 205:2734.
18. Baker, R. D., 1962. Leukopenia and therapy in leukemia as factors predisposing to fatal mycoses. Mucormycosis, aspergillosis, and cryptococcosis. Am. J. Clin. Pathol. 37:358373.
19. Baker, R. D., 1957. Mucormycosis; a new disease? JAMA 163:805808.
20. Baldwin, D. A.,, D. M. De Sousa, and, R. M. Von Wandruszka. 1982. The effect of pH on the kinetics of iron release from human transferrin. Biochim. Biophys. Acta 719:140146.
21. Barron, M. A.,, M. Lay, and, N. E. Madinger. 2005. Surgery and treatment with high-dose liposomal amphotericin B for eradication of craniofacial zygomycosis in a patient with Hodgkin’s disease who had undergone allogeneic hematopoietic stem cell transplantation. J. Clin. Microbiol. 43:20122014.
22. Bearer, E. A.,, P. R. Nelson,, M. Y. Chowers, and, C. E. Davis. 1994. Cutaneous zygomycosis caused by Saksenaea vasiformis in a diabetic patient. J. Clin. Microbiol. 32:18231824.
23. Beck-Sague, C.,, W. R. Jarvis, et al., 1993. Secular trends in the epidemiology of nosocomial fungal infections in the United States, 1980–1990. J. Infect. Dis. 167:12471251.
24. Belin, L., 1980. Clinical and immunological data on “wood trimmer’s disease” in Sweden. Eur. J. Respir. Dis. Suppl. 107:169176.
25. Benbow, E. W.,, I. W. Delamore,, R. W. Stoddart, and, H. Reid. 1985. Disseminated zygomycosis associated with erythroleukaemia: confirmation by lectin stains. J. Clin. Pathol. 38:10391044.
26. Bentur, Y.,, A. Shupak,, Y. Ramon,, A. Abramovich,, G. Wolfin,, H. Stein, and, N. Krivoi. 1998. Hyperbaric oxygen therapy for cutaneous/soft-tissue zygomycosis complicating diabetes mellitus. Plast. Reconstr. Surg. 102:822824.
27. Bhaduri, S.,, E. Kurrle,, E. Vanek, and, R. Spanel. 1983. Mucormycosis in the immunocompromised host. Infection 11:170172.
28. Bhatia, S.,, J. McCullough,, E. H. Perry,, M. Clay,, N. K. Ramsay, and, J. P. Neglia. 1994. Granulocyte transfusions: efficacy in treating fungal infections in neutropenic patients following bone marrow transplantation. Transfusion 34:226232.
29. Birchall, D.,, W. K. Leong, and, W. McAuliffe. 1999. Cerebral mucormycosis. J. Neurol. Neurosurg. Psychiatry 66:404405.
30. Blitzer, A.,, W. Lawson,, B. R. Meyers, and, H. F. Biller. 1980. Patient survival factors in paranasal sinus mucormycosis. Laryngoscope 90:635648.
31. Blodi, F. C.,, F. T. Hannah, and, J. A. Wadsworth. 1969. Lethal orbito-cerebral phycomycosis in otherwise healthy children. Am. J. Ophthalmol. 67:698705.
32. Bloxham, C. A.,, S. Carr,, D. W. Ryan,, P. J. Kesteven,, R. S. Bexton,, I. D. Griffiths, and, J. Richards. 1990. Disseminated zygomycosis and systemic lupus erythematosus. Intensive Care Med. 16:201207.
33. Boelaert, J. R.,, M. de Locht,, J. Van Cutsem,, V. Kerrels,, B. Cantinieaux,, A. Verdonck,, H. W. Van Landuyt, and, Y. J. Schneider. 1993. Mucormycosis during deferoxamine therapy is a siderophore-mediated infection. In vitro and in vivo animal studies. J. Clin. Invest. 91:19791986.
34. Boelaert, J. R.,, A. Z. Fenves, and, J. W. Coburn. 1991. Deferoxamine therapy and mucormycosis in dialysis patients: report of an international registry. Am. J. Kidney Dis. 18:660667.
35. Boelaert, J. R.,, J. Van Cutsem,, M. de Locht,, Y. J. Schneider, and, R. R. Crichton. 1994. Deferoxamine augments growth and pathogenicity of Rhizopus, while hydroxypyridinone chelators have no effect. Kidney Int. 45:667671.
36. Boelaert, J. R.,, G. F. van Roost,, P. L. Vergauwe,, J. J. Verbanck,, C. de Vroey, and, M. F. Segaert. 1988. The role of desferrioxamine in dialysis-associated mucormycosis: report of three cases and review of the literature. Clin. Nephrol. 29:261266.
37. Bogard, B. N., 1972. Pulmonary mucormycosis. N. Engl. J. Med. 286:606.
38. Bottone, E. J.,, I. Weitzman, and, B. A. Hanna. 1979. Rhizopus rhizopodiformis: emerging etiological agent of mucormycosis. J. Clin. Microbiol. 9:530537.
39. Boucher, H. W.,, A. H. Groll,, C. C. Chiou, and, T. J. Walsh. 2004. Newer systemic antifungal agents: pharmacokinetics, safety and efficacy. Drugs 64:19972020.
40. Boyce, J. M.,, L. A. Lawson,, W. R. Lockwood, and, J. L. Hughes. 1981. Cunninghamella bertholletiae wound infection of probable nosocomial origin. South. Med. J. 74:11321135.
41. Boyle, J. A., 2000. Controlled trials of amphotericin B lipid complex. Clin. Infect. Dis. 31:11171118.
42. Bradley, R.,, B. R. Straatsma, and, E. Lorenz. 1962. Phycomycosis: a clinicopathologic study of fifty-one cases. Lab. Investigo. 11:963985.
43. Bragg, G. D., and, B. Janis. 1973. The roentgenographic manifestations of pulmonary opportunistic infections. Am. J. Roentgenol. Radium Ther. Nucl. Med. 117:798809.
44. Brandt, S. J.,, W. P. Peters,, S. K. Atwater,, J. Kurtzberg,, M. J. Borowitz,, R. B. Jones,, E. J. Shpall,, R. C. Bast, Jr.,, C. J. Gilbert, and, D. H. Oette. 1988. Effect of recombinant human granulocyte-macrophage colony-stimulating factor on hematopoietic reconstitution after high-dose chemotherapy and autologous bone marrow transplantation. N. Engl. J. Med. 318:869876.
45. Branton, M. H.,, S. C. Johnson,, J. D. Brooke, and, J. A. Hasbargen. 1991. Peritonitis due to Rhizopus in a patient undergoing continuous ambulatory peritoneal dialysis. Rev. Infect. Dis. 13:19–21.
46. Briones, M. A.,, C. D. Josephson, and, C. D. Hillyer. 2003. Granulocyte transfusion: revisited. Curr. Hematol. Rep. 2:522527.
47. Brown, R. B.,, J. H. Johnson,, J. M. Kessinger, and, W. C. Sealy. 1992. Bronchovascular mucormycosis in the diabetic: an urgent surgical problem. Ann. Thorac. Surg. 53:854855.
48. Bruck, H. M.,, G. Nash,, D. Foley, and, B. A. Pruitt, Jr., 1971. Opportunistic fungal infection of the burn wound with phycomycetes and Aspergillus. A clinical-pathologic review. Arch. Surg. 102:476482.
49. Bullock, J. D.,, L. M. Jampol, and, A. J. Fezza. 1974. Two cases of orbital phycomycosis with recovery. Am. J. Ophthalmol. 78:811815.
50. Burkitt, D. P.,, A. M. Wilson, and, D. B. Jelliffe. 1964. Subcutaneous phycomycosis: a review of 31 cases seen in Uganda. Br. Med. J. i:16691672.
51. Busapakum, R.,, U. Youngchaiyud,, S. Sriumpai,, G. Segretain, and, H. Fromentin. 1983. Disseminated infection with Conidiobolus incongruus. Sabouraudia 21:323330.
52. Bybee, J. D., and, D. E. Rogers. 1964. The phagocytic activity of polymorphonuclear leukocytes obtained from patients with diabetes mellitus. J. Lab. Clin. Med. 64:113.
53. Caceres, A. M.,, C. Sardinas,, C. Marcano,, R. Guevara,, J. Barros,, G. Bianchi,, V. Rosario,, R. Balza,, M. Silva,, M. C. Redondo, and, M. Nunez. 1997. Apophysomyces elegans limb infection with a favorable outcome: case report and review. Clin. Infect. Dis. 25:331332.
54. Caldwell, J., 1963. Effects of high partial pressures of oxygen on fungi. Nature 197:772774.
55. Calle, S., and, S. Klatsky. 1966. Intestinal phycomycosis (mucormycosis). Am. J. Clin. Pathol. 45:264272.
56. Carpenter, C. F., and, A. K. Subramanian. 1999. Images in clinical medicine. Cutaneous zygomycosis (mucormycosis). N. Engl. J. Med. 341:1891.
57. Carr, E. J.,, P. Scott, and, J. D. Gradon. 1999. Fatal gastrointestinal mucormycosis that invaded the postoperative abdominal wall wound in an immunocompetent host. Clin. Infect. Dis. 29:956957.
58. Castelli, J. B., and, J. L. Pallin. 1978. Lethal rhinocerebral phycomycosis in a healthy adult: a case report and review of the literature. Otolaryngology 86:696703.
59. Cefai, C.,, T. S. Elliott,, R. W. Nutton,, A. E. Lockett, and, J. Pooley. 1987. Zygomycetic gangrenous cellulitis. Lancet ii:13371338.
60. Chakrabarti, A.,, P. Kumar,, A. A. Padhye,, L. Chatha,, S. K. Singh,, A. Das,, J. D. Wig, and, R. N. Kataria. 1997. Primary cutaneous zygomycosis due to Saksenaea vasiformis and Apophysomyces elegans. Clin. Infect. Dis. 24:580583.
61. Chan, L. L.,, S. Singh,, D. Jones,, E. M. Diaz, Jr., and, L. E. Ginsberg. 2000. Imaging of mucormycosis skull base osteomyelitis. Am. J. Neuroradiol. 21:828831.
62. Chaudhry, R.,, P. Venugopal, and, P. Chopra. 1987. Prosthetic mitral valve mucormycosis caused by Mucor species. Int. J. Cardiol. 17:333335.
63. Chetchotisakd, P.,, M. Boonma, and, M. Sookprane. 1991. Rhinocerebral mucormycosis: a report of eleven cases. Southeast Asian J. Trop. Med. Public Health 22:268271.
64. Cho, S. Y., and, H. Y. Choi. 1979. Opportunistic fungal infection among cancer patients. A ten-year autopsy study. Am. J. Clin. Pathol. 72:617621.
65. Chugh, K. S.,, V. Sakhuja,, K. L. Gupta,, V. Jha,, A. Chakravarty,, N. Malik,, P. Kathuria,, N. Pahwa, and, O. P. Kalra. 1993. Renal mucormycosis: computerized tomographic findings and their diagnostic significance. Am. J. Kidney Dis. 22:393397.
66. Clark, R.,, D. L. Greer,, T. Carlisle, and, B. Carroll. 1990. Cutaneous zygomycosis in a diabetic HTLV-I-seropositive man. J. Am. Acad. Dermatol. 22:956959.
67. Cocanour, C. S.,, P. Miller-Crotchett,, R. L. Reed II,, P. C. Johnson, and, R. P. Fischer. 1992. Mucormycosis in trauma patients. J. Trauma 32:1215.
68. Coelho Filho, J. C.,, J. Pereira, and, A. Rabello, Jr., 1989. Mediastinal and pulmonary entomophthoromycosis with superior vena cava syndrome: case report. Rev. Inst. Med. Trop. Sao Paulo 31:430433.
69. Cohen, S. G., and, M. S. Greenberg. 1980. Rhinomaxillary mucormycosis in a kidney transplant patient. Oral Surg. Oral Med. Oral Pathol. 50:3338.
70. Collins, D. M.,, T. A. Dillard,, K. W. Grathwohl,, G. N. Giacoppe, and, B. F. Arnold. 1999. Bronchial mucormycosis with progressive air trapping. Mayo Clin. Proc. 74:698701.
71. Connor, B. A.,, R. J. Anderson, and, J. W. Smith. 1979. Mucor mediastinitis. Chest 75:525526.
72. Cooter, R. D.,, I. S. Lim,, D. H. Ellis, and, I. O. Leitch. 1990. Burn wound zygomycosis caused by Apophysomyces elegans. J. Clin. Microbiol. 28:21512153.
73. Couch, L.,, F. Theilen, and, J. T. Mader. 1988. Rhinocerebral mucormycosis with cerebral extension successfully treated with adjunctive hyperbaric oxygen therapy. Arch. Otolaryngol. Head Neck Surg. 114:791794.
74. Craig, N. M.,, F. L. Lueder,, J. M. Pensler,, B. S. Bean,, M. L. Petrick,, R. B. Thompson, and, L. R. Eramo. 1994. Disseminated Rhizopus infection in a premature infant. Pediatr. Dermatol. 11:346350.
75. Cuadrado, L. M.,, A. Guerrero,, J. A. Garcia Asenjo,, F. Martin,, E. Palau, and, D. Garcia Urra. 1988. Cerebral mucormycosis in two cases of acquired immunodeficiency syndrome. Arch. Neurol. 45:109111.
76. Dannaoui, E.,, J. Afeltra,, J. F. Meis, and, P. E. Verweij. 2002. In vitro susceptibilities of zygomycetes to combinations of antimicrobial agents. Antimicrob. Agents Chemother. 46:27082711.
77. Dannaoui, E.,, J. F. Meis,, D. Loebenberg, and, P. E. Verweij. 2003. Activity of posaconazole in treatment of experimental disseminated zygomycosis. Antimicrob. Agents Chemother. 47:36473650.
78. Dannaoui, E.,, J. Meletiadis,, J. W. Mouton,, J. F. Meis, and, P. E. Verweij. 2003. In vitro susceptibilities of zygomycetes to conventional and new antifungals. J. Antimicrob. Chemother. 51:4552.
79. Dannheimer, I. P.,, W. Fouche, and, C. Nel. 1974. Gastric mucormycosis in a diabetic patient. S. Afr. Med. J. 48:838839.
80. Dansky, A. S.,, C. M. Lynne, and, V. A. Politano. 1978. Disseminated mucormycosis with renal involvement. J. Urol. 119:275277.
81. Darrisaw, L.,, G. Hanson,, D. H. Vesole, and, S. C. Kehl. 2000. Cunninghamella infection post bone marrow transplant: case report and review of the literature. Bone Marrow Transplant. 25:12131216.
82. Davila, R. M.,, S. A. Moser, and, L. E. Grosso. 1991. Renal mucormycosis: a case report and review of the literature. J. Urol. 145:12421244.
83. Deal, W. B., and, J. E. Johnson III., 1969. Gastric phycomycosis. Report of a case and review of the literature. Gastroenterology 57:579586.
84. Dean, D. F.,, L. Ajello,, R. S. Irwin,, W. K. Woelk, and, G. J. Skarulis. 1977. Cranial zygomycosis caused by Saksenaea vasiformis. Case report. J. Neurosurg. 46:97103.
85. De La Paz, M. A.,, J. R. Patrinely,, H. M. Marines, and, W. D. Appling. 1992. Adjunctive hyperbaric oxygen in the treatment of bilateral cerebro-rhino-orbital mucormycosis. Am. J. Ophthalmol. 114:208211.
86. de Locht, M.,, J. R. Boelaert, and, Y. J. Schneider. 1994. Iron uptake from ferrioxamine and from ferrirhizoferrin by germinating spores of Rhizopus microsporus. Biochem. Pharmacol. 47:18431850.
87. del Palacio Hernanz, A.,, J. Fereres,, S. Larregla Garraus,, A. Rodriguez-Noriega, and, F. Sanz Sanz. 1983. Nosocomial infection by Rhizomucor pusillus in a clinical haematology unit. J. Hosp. Infect. 4:4549.
88. Demirag, A.,, E. A. Elkhammas,, M. L. Henry,, E. A. Davies,, R. P. Pelletier,, G. L. Bumgardner,, B. Dorner, and, R. M. Ferguson. 2000. Pulmonary Rhizopus infection in a diabetic renal transplant recipient. Clin. Transplant. 14:810.
89. Denning, D. W., 1991. Epidemiology and pathogenesis of systemic fungal infections in the immunocompromised host. J. Antimicrob. Chemother. 28(Suppl. B):116.
90. Dennis, J. E.,, K. H. Rhodes, and, D. R. Cooney. 1980. Nosocomial Rhizopus infection (zygomycosis) in children. J. Pediatr. 96:824828.
91. deShazo, R. D.,, M. O’Brien,, K. Chapin,, M. Soto-Aguilar,, L. Gardner, and, R. Swain. 1997. A new classification and diagnostic criteria for invasive fungal sinusitis. Arch. Otolaryngol. Head Neck Surg. 123:11811188.
92. Deshpande, A. H., and, M. M. Munshi. 2000. Rhinocerebral mucormycosis diagnosis by aspiration cytology. Diagn. Cytopathol. 23:97100.
93. Diamond, H. J.,, R. G. Phelps,, M. L. Gordon,, E. Lambroza,, H. Namdari, and, E. J. Bottone. 1992. Combined Aspergillus and zygomycotic (Rhizopus) infection in a patient with acquired immunodeficiency syndrome. Presentation as inflammatory tinea capitis. J. Am. Acad. Dermatol. 26:10171018.
94. Diamond, R. D., and, R. A. Clark. 1982. Damage to Aspergillus fumigatus and Rhizopus oryzae hyphae by oxidative and nonoxidative microbicidal products of human neutrophils in vitro. Infect. Immun. 38:487495.
95. Dickinson, M.,, T. Kalayanamit,, C. A. Yang,, G. J. Pomper,, C. Franco-Webb, and, D. Rodman. 1998. Cutaneous zygomycosis (mucormycosis) complicating endotracheal intubation: diagnosis and successful treatment. Chest 114:340342.
96. Diekema, D. J.,, S. A. Messer,, R. J. Hollis,, R. N. Jones, and, M. A. Pfaller. 2003. Activities of caspofungin, itraconazole, posaconazole, ravuconazole, voriconazole, and amphotericin B against 448 recent clinical isolates of filamentous fungi. J. Clin. Microbiol. 41:36233626.
97. Dupont, B., 2005. Pulmonary mucormycosis (zygomycosis) in a lung transplant recipient: recovery after posaconazole therapy. Transplantation 80:544545.
98. Dykhuizen, R. S.,, K. N. Kerr, and, R. L. Soutar. 1994. Air crescent sign and fatal haemoptysis in pulmonary mucormycosis. Scand. J. Infect. Dis. 26:498501.
99. Eaton, M. E.,, A. A. Padhye,, D. A. Schwartz, and, J. P. Steinberg. 1994. Osteomyelitis of the sternum caused by Apophysomyces elegans. J. Clin. Microbiol. 32:28272828.
100. Eckert, H. L.,, G. H. Khoury,, R. S. Pore,, E. F. Gilbert, and, J. R. Gaskell. 1972. Deep Entomophthora phycomycotic infection reported for the first time in the United States. Chest 61:392394.
101. Eckmann, D. M.,, I. Seligman,, C. J. Cote, and, J. W. Hussong. 1998. Mucormycosis supraglottitis on induction of anesthesia in an immunocompromised host. Anesth. Analg. 86:729730.
102. Eisen, D. P., and, J. Robson. 2004. Complete resolution of pulmonary Rhizopus oryzae infection with itraconazole treatment: more evidence of the utility of azoles for zygomycosis. Mycoses 47:159162.
103. Eiser, A. R.,, R. F. Slifkin, and, M. S. Neff. 1987. Intestinal mucormycosis in hemodialysis patients following deferoxamine. Am. J. Kidney Dis. 10:7173.
104. El-Ani, A. S., and, V. Dhar. 1982. Disseminated mucormycosis in a case of metastatic carcinoma. Am. J. Clin. Pathol. 77:110114.
105. Elder, T. D., and, R. D. Baker. 1956. Pulmonary mucormycosis in rabbits with alloxan diabetes; increased invasiveness of fungus during acute toxic phase of diabetes. AMA Arch. Pathol. 61:159168.
106. Eng, R. H.,, A. Person,, C. Mangura,, H. Chmel, and, M. Corrado. 1981. Susceptibility of zygomycetes to amphotericin B, miconazole, and ketoconazole. Antimicrob. Agents Chemother. 20:688690.
107. England, A. C., III,, M. Weinstein,, J. J. Ellner, and, L. Ajello. 1981. Two cases of rhinocerebral zygomycosis (mucormycosis) with common epidemiologic and environmental features. Am. Rev. Respir. Dis. 124:497498.
108. Erdos, M. S.,, K. Butt, and, L. Weinstein. 1972. Mucormycotic endocarditis of the pulmonary valve. JAMA 222:951953.
109. Espinel-Ingroff, A., 2001. In vitro fungicidal activities of voriconazole, itraconazole, and amphotericin B against opportunistic moniliaceous and dematiaceous fungi. J. Clin. Microbiol. 39:954958.
110. Espinoza, C. G., and, D. G. Halkias. 1983. Pulmonary mucormycosis as a complication of chronic salicylate poisoning. Am. J. Clin. Pathol. 80:508511.
111. Fairley, C.,, T. J. Sullivan,, P. Bartley,, T. Allworth, and, R. Lewandowski. 2000. Survival after rhinoorbital-cerebral mucormycosis in an immunocompetent patient. Ophthalmology 107:555558.
112. Feeley, M. A.,, P. D. Righi,, T. E. Davis, and, A. Greist. 1999. Mucormycosis of the paranasal sinuses and septum. Otolaryngol. Head Neck Surg. 120:750.
113. Fergie, J. E.,, D. S. Fitzwater,, P. Einstein, and, R. J. Leggiadro. 1992. Mucor peritonitis associated with acute peritoneal dialysis. Pediatr. Infect. Dis. J. 11:498500.
114. Ferguson, B. J., 2000. Mucormycosis of the nose and paranasal sinuses. Otolaryngol. Clin. N. Am. 33:349365.
115. Ferguson, B. J.,, T. G. Mitchell,, R. Moon,, E. M. Camporesi, and, J. Farmer. 1988. Adjunctive hyperbaric oxygen for treatment of rhinocerebral mucormycosis. Rev. Infect. Dis. 10:551559.
116. Fermanis, G. G.,, K. S. Matar, and, R. Steele. 1991. Endobronchial zygomycosis. Aust. N. Z. J. Surg. 61:391393.
117. Fingerote, R. J.,, S. Seigel,, M. H. Atkinson, and, R. M. Lewkonia. 1990. Disseminated zygomycosis associated with systemic lupus erythematosus. J. Rheumatol. 17:16921694.
118. Fisher, E. W.,, A. Toma,, P. H. Fisher, and, A. D. Cheesman. 1991. Rhinocerebral mucormycosis: use of liposomal amphotericin B. J. Laryngol. Otol. 105:575577.
119. Fisher, J.,, C. U. Tuazon, and, G. W. Geelhoed. 1980. Mucormycosis in transplant patients. Am. Surg. 46:315322.
120. Flood, H. D.,, A. M. O’Brien, and, D. G. Kelly. 1985. Isolated renal mucormycosis. Postgrad. Med. J. 61:175176.
121. Foley, F. D., and, J. M. Shuck. 1968. Burn-wound infection with phycomycetes requiring amputation of hand. JAMA 203:596.
122. Fong, K. M.,, E. M. Seneviratne, and, J. G. McCormack. 1990. Mucor cerebral abscess associated with intravenous drug abuse. Aust. N. Z. J. Med. 20:7477.
123. Fridkin, S. K., and, W. R. Jarvis. 1996. Epidemiology of nosocomial fungal infections. Clin. Microbiol. Rev. 9:499511.
124. Funada, H., and, T. Matsuda. 1996. Pulmonary mucormycosis in a hematology ward. Intern. Med. 35:540544.
125. Gale, A. M., and, W. P. Kleitsch. 1972. Solitary pulmonary nodule due to phycomycosis (mucormycosis). Chest 62:752755.
126. Galetta, S. L.,, A. E. Wulc,, H. I. Goldberg,, C. W. Nichols, and, J. S. Glaser. 1990. Rhinocerebral mucormycosis: management and survival after carotid occlusion. Ann. Neurol. 28:103107.
127. Garbino, J.,, I. Uckay,, K. Amini,, M. Puppo,, M. Richter, and, D. Lew. 2005. Absidia posttraumatic infection: successful treatment with posaconazole. J. Infect. 51:e135e138.
128. Gartenberg, G.,, E. J. Bottone,, G. T. Keusch, and, I. Weitzman. 1978. Hospital-acquired mucormycosis (Rhizopus rhizopodiformis) of skin and subcutaneous tissue: epidemiology, mycology and treatment. N. Engl. J. Med. 299:11151118.
129. Gass, J. D., 1961. Ocular manifestations of acute mucormycosis. Arch. Ophthalmol. 65:226237.
130. Gaviria, J. M.,, L. A. Grohskopf,, R. Barnes, and, R. K. Root. 1999. Successful treatment of rhinocerebral zygomycosis: a combined-strategy approach. Clin. Infect. Dis. 28:160161.
131. Gaziev, D.,, D. Baronciani,, M. Galimberti,, P. Polchi,, E. Angelucci,, C. Giardini,, P. Muretto,, S. Perugini,, S. Riggio,, S. Ghirlanda,, B. Erer,, A. Maiello, and, G. Lucarelli. 1996. Mucormycosis after bone marrow transplantation: report of four cases in thalassemia and review of the literature. Bone Marrow Transplant. 17:409414.
132. Gilbert, E. F.,, G. H. Khoury, and, R. S. Pore. 1970. Histopathological identification of Entomophthora phycomycosis. Deep mycotic infection in an infant. Arch. Pathol. 90:583587.
133. Gil-Lamaignere, C.,, M. Simitsopoulou,, E. Roilides,, A. Maloukou,, R. M. Winn, and, T. J. Walsh. 2005. Interferon-gamma and granulocyte-macrophage colony-stimulating factor augment the activity of polymorphonuclear leukocytes against medically important zygomycetes. J. Infect. Dis. 191:11801187.
134. Gilman, A. L.,, A. Serrano,, J. Skelley, and, D. Zwick. 2005. Successful treatment of pulmonary zygomycosis with posaconazole in a recipient of a haploidentical donor stem cell transplant. Pediatr. Blood Cancer. Epub ahead of print.
135. Glazer, M.,, S. Nusair,, R. Breuer,, J. Lafair,, Y. Sherman, and, N. Berkman. 2000. The role of BAL in the diagnosis of pulmonary mucormycosis. Chest 117:279282.
136. Gleissner, B.,, A. Schilling,, I. Anagnostopolous,, I. Siehl, and, E. Thiel. 2004. Improved outcome of zygomycosis in patients with hematological diseases? Leuk. Lymphoma 45:13511360.
137. Gokcil, Z.,, Z. Odabasi,, Y. Kutukcu,, H. Umudum,, O. Vural, and, M. Yardim. 1998. Rhino-orbito-cerebral mucormycosis. J. Neurol. 245:689690.
138. Goldstein, M. F.,, D. J. Dvorin,, E. H. Dunsky,, R. W. Lesser,, P. J. Heuman, and, J. H. Loose. 1992. Allergic Rhizomucor sinusitis. J. Allergy Clin. Immunol. 90:394404.
139. Gonis, G., and, M. Starr. 1997. Fatal rhinoorbital mucormycosis caused by Saksenaea vasiformis in an immunocompromised child. Pediatr. Infect. Dis. J. 16:714716.
140. Gonzalez, C. E.,, D. R. Couriel, and, T. J. Walsh. 1997. Disseminated zygomycosis in a neutropenic patient: successful treatment with amphotericin B lipid complex and granulocyte colony-stimulating factor. Clin. Infect. Dis. 24:192196.
141. Goodman, J. L.,, D. J. Winston,, R. A. Greenfield,, P. H. Chandrasekar,, B. Fox,, H. Kaizer,, R. K. Shad-duck,, T. C. Shea,, P. Stiff,, D. J. Friedman, et al. 1992. A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation. N. Engl. J. Med. 326:845851.
142. Goodnight, J.,, P. Dulguerov, and, E. Abemayor. 1993. Calcified mucor fungus ball of the maxillary sinus. Am. J. Otolaryngol. 14:209210.
143. Gordon, G.,, M. Indeck,, J. Bross,, D. A. Kapoor, and, S. Brotman. 1988. Injury from silage wagon accident complicated by mucormycosis. J. Trauma 28:866867.
144. Gottlieb, S. F., 1965. Hyperbaric oxygenation. Adv. Clin. Chem. 8:69139.
145. Grauer, M. E.,, C. Bokemeyer,, T. Welte,, M. Freund, and, H. Link. 1993. Successful treatment of Mucor pneumonia in a patient with relapsed lymphoblastic leukemia after bone marrow transplantation. Bone Marrow Transplant. 12:421.
146. Graus, F.,, L. R. Rogers, and, J. B. Posner. 1985. Cerebrovascular complications in patients with cancer. Medicine (Baltimore) 64:1635.
147. Green, W. R., and, D. Bouchette. 1986. Pleural mucormycosis (zygomycosis). Arch. Pathol. Lab. Med. 110:441442.
148. Greenberg, M. R.,, S. M. Lippman,, V. S. Grinnell,, M. F. Colman, and, J. E. Edwards, Jr., 1985. Computed tomographic findings in orbital Mucor. West. J. Med. 143:102103.
149. Greenberg, R. N.,, L. J. Scott,, H. H. Vaughn, and, J. A. Ribes. 2004. Zygomycosis (mucormycosis): emerging clinical importance and new treatments. Curr. Opin. Infect. Dis. 17:517525.
150. Guardia, J. A.,, J. Bourgoignie, and, J. Diego. 2000. Renal mucormycosis in the HIV patient. Am. J. Kidney Dis. 35:e24.
151. Gupta, A. K.,, S. B. Mann,, V. K. Khosla,, K. V. Sastry, and, J. S. Hundal. 1999. Non-randomized comparison of surgical modalities for paranasal sinus mycoses with intracranial extension. Mycoses 42:225230.
152. Gupta, K. L.,, K. Joshi,, B. J. Pereira, and, K. Singh. 1987. Disseminated mucormycosis presenting with acute renal failure. Postgrad. Med. J. 63:297299.
153. Gupta, K. L.,, K. Joshi,, K. Sud,, H. S. Kohli,, V. Jha,, B. D. Radotra, and, V. Sakhuja. 1999. Renal zygomycosis: an under-diagnosed cause of acute renal failure. Nephrol. Dial. Transplant. 14:27202725.
154. Hagensee, M. E.,, J. E. Bauwens,, B. Kjos, and, R. A. Bowden. 1994. Brain abscess following marrow transplantation: experience at the Fred Hutchinson Cancer Research Center, 1984–1992. Clin. Infect. Dis. 19:402408.
155. Hameroff, S. B.,, J. W. Eckholdt, and, R. Lindenberg. 1970. Cerebral phycomycosis in a heroin addict. Neurology 20:261265.
156. Hammond, D. E., and, R. K. Winkelmann. 1979. Cutaneous phycomycosis. Report of three cases with identification of Rhizopus. Arch. Dermatol. 115:990992.
157. Harada, M.,, T. Manabe,, K. Yamashita, and, N. Okamoto. 1992. Pulmonary mucormycosis with fatal massive hemoptysis. Acta Pathol. Jpn. 42:4955.
158. Harper, J. J.,, C. Coulter,, G. R. Lye, and, G. R. Nimmo. 1996. Rhizopus and tongue depressors. Lancet 348:1250.
159. Helenglass, G.,, J. A. Elliott, and, N. P. Lucie. 1981. An unusual presentation of opportunistic mucormycosis. Br. Med. J. 282:108109.
160. Hicks, W. L., Jr.,, K. Nowels, and, J. Troxel. 1995. Primary cutaneous mucormycosis. Am. J. Otolaryngol. 16:265268.
161. Hoffman, R. M., 1987. Chronic endobronchial mucormycosis. Chest 91:469.
162. Hopkins, R. J.,, M. Rothman,, A. Fiore, and, S. E. Goldblum. 1994. Cerebral mucormycosis associated with intravenous drug use: three case reports and review. Clin. Infect. Dis. 19:11331137.
163. Hopwood, V.,, D. A. Hicks,, S. Thomas, and, E. G. Evans. 1992. Primary cutaneous zygomycosis due to Absidia corymbifera in a patient with AIDS. J. Med. Vet. Mycol. 30:399402.
164. Hosseini, M., and, J. Lee. 1998. Gastrointestinal mucormycosis mimicking ischemic colitis in a patient with systemic lupus erythematosus. Am. J. Gastroenterol. 93:13601362.
165. Huffnagle, K. E.,, P. M. Southern, Jr.,, L. T. Byrd, and, R. M. Gander. 1992. Apophysomyces elegans as an agent of zygomycosis in a patient following trauma. J. Med. Vet. Mycol. 30:8386.
166. Humphry, R. C.,, G. Wright,, W. J. Rich, and, R. Simpson. 1989. Acute proptosis and blindness in a patient with orbital phycomycosis. J. R. Soc. Med. 82:304305.
167. Hunstad, D. A.,, A. H. Cohen, and, J. W. St Geme III., 1999. Successful eradication of mucormycosis occurring in a pulmonary allograft. J. Heart. Lung Transplant. 18:801804.
168. Hyatt, D. S.,, Y. M. Young,, K. A. Haynes,, J. M. Taylor,, D. M. McCarthy, and, T. R. Rogers. 1992. Rhinocerebral mucormycosis following bone marrow transplantation. J. Infect. 24:6771.
169. Ibrahim, A. S.,, B. Spellberg,, V. Avanessian,, Y. Fu, and, J. E. Edwards, Jr., 2005. Rhizopus oryzae adheres to, is phagocytosed by, and damages endothelial cells in vitro. Infect. Immun. 73:778783.
170. Ignelzi, R. J., and, G. D. VanderArk. 1975. Cerebral mucormycosis following open head trauma. Case report. J. Neurosurg. 42:593596.
171. Imhof, A.,, S. A. Balajee,, D. N. Fredricks,, J. A. Englund, and, K. A. Marr. 2004. Breakthrough fungal infections in stem cell transplant recipients receiving voriconazole. Clin. Infect. Dis. 39:743746.
172. Inamasu, J.,, K. Uchida,, K. Mayanagi,, S. Suga, and, T. Kawase. 2000. Basilar artery occlusion due to mucormycotic emboli, preceded by acute hydrocephalus. Clin. Neurol. Neurosurg. 102:1822.
173. Ingram, C. W.,, J. Sennesh,, J. N. Cooper, and, J. R. Perfect. 1989. Disseminated zygomycosis: report of four cases and review. Rev. Infect. Dis. 11:741754.
174. Iqbal, S. M., and, R. L. Scheer. 1986. Myocardial mucormycosis with emboli in a hemodialysis patient. Am. J. Kidney Dis. 8:455458.
175. Iwen, P. C.,, M. E. Rupp, and, S. H. Hinrichs. 1997. Invasive mold sinusitis: 17 cases in immunocompromised patients and review of the literature. Clin. Infect. Dis. 24:11781184.
176. Jaffey, P. B.,, A. K. Haque,, M. el-Zaatari,, L. Pasarell, and, M. R. McGinnis. 1990. Disseminated Conidiobolus infection with endocarditis in a cocaine abuser. Arch. Pathol. Lab. Med. 114:12761278.
177. Jain, J. K.,, A. Markowitz,, P. V. Khilanani, and, C. B. Lauter. 1978. Localized mucormycosis following intramuscular corticosteroid. Case report and review of the literature. Am. J. Med. Sci. 275:209216.
178. Jamadar, D. A.,, E. A. Kazerooni,, B. D. Daly,, C. S. White, and, B. H. Gross. 1995. Pulmonary zygomycosis: CT appearance. J. Comput. Assist. Tomogr. 19:733738.
179. Jantunen, E.,, E. Kolho,, P. Ruutu,, P. Koukila-Kahkola,, M. Virolainen,, E. Juvonen, and, L. Volin. 1996. Invasive cutaneous mucormycosis caused by Absidia corymbifera after allogeneic bone marrow transplantation. Bone Marrow Transplant. 18:229230.
180. Jensen, A. B., and, K. M. Dromph. 2005. The causal agents of ‘entomophthoramycosis’ belong to two different orders: a suggestion for modification of the clinical nomenclature. Clin. Microbiol. Infect. 11:249250.
181. Jensen, A. B.,, A. Gargas,, J. Eilenberg, and, S. Rosendahl. 1998. Relationships of the insect-pathogenic order Entomophthorales (Zygomycota, Fungi) based on phylogenetic analyses of nuclear small subunit ribosomal DNA sequences (SSU rDNA). Fungal Genet. Biol. 24:325334.
182. John, B. V.,, G. Chamilos, and, D. P. Kontoyiannis. 2005. Hyperbaric oxygen as an adjunctive treatment for zygomycosis. Clin. Microbiol. Infect. 11:515517.
183. Josefiak, E. J.,, J. H. Foushee, and, L. C. Smith. 1958. Cutaneous mucormycosis. Am. J. Clin. Pathol. 30:547552.
184. Kahn, L. B., 1963. Gastric mucormycosis: report of a case with a review of the literature. S. Afr. Med. J. 37:12651269.
185. Kajs-Wyllie, M., 1995. Hyperbaric oxygen therapy for rhinocerebral fungal infection. J. Neurosci. Nurs. 27:174181.
186. Kamalam, A., and, A. S. Thambiah. 1980. Cutaneous infection by Syncephalastrum. Sabouraudia 18:1920.
187. Kamat, S. R.,, S. P. Shah,, A. A. Mahashur,, D. C. Shah, and, A. P. Mehta. 1982. Disseminated systemic mucormycosis (a case report). J. Postgrad. Med. 28:229232.
188. Kaplan, A. L.,, A. R. Huerta, and, S. J. Chiou. 1981. Rhinocerebral mucormycosis. West. J. Med. 135:326329.
189. Karsner, H. T., and, O. Saphir. 1926. Influence of high partial pressures of oxygen on the growth of certain molds. J. Infect. Dis. 39:231236.
190. Kauffman, C. A., 2004. Zygomycosis: reemergence of an old pathogen. Clin. Infect. Dis. 39:588590.
191. Kecskes, S.,, G. Reynolds, and, G. Bennett. 1997. Survival after gastrointestinal mucormycosis in a neonate. J. Paediatr. Child Health 33:356359.
192. Kerr, P. G.,, H. Turner,, A. Davidson,, C. Bennett, and, M. Maslen. 1988. Zygomycosis requiring amputation of the hand: an isolated case in a patient receiving haemodialysis. Med. J. Aust. 148:258259.
193. Keys, T. F.,, A. M. Haldorson, and, K. H. Rhodes. 1978. Nosocomial outbreak of Rhizopus infections associated with Elastoplast wound dressings. Morb. Mortal. Wkly. Rep. 27:3334.
194. Khardori, N.,, S. Hayat,, K. Rolston, and, G. P. Bodey. 1989. Cutaneous Rhizopus and Aspergillus infections in five patients with cancer. Arch. Dermatol. 125:952956.
195. Khicha, G. J.,, R. B. Berroya,, F. B. Escano, Jr., and, C. S. Lee. 1972. Mucormycosis in a mitral prosthesis. J. Thorac. Cardiovasc. Surg. 63:903905.
196. Kiehn, T. E.,, F. Edwards,, D. Armstrong,, P. P. Rosen, and, I. Weitzman. 1979. Pneumonia caused by Cunninghamella bertholletiae complicating chronic lymphatic leukemia. J. Clin. Microbiol. 10:374379.
197. Kimura, M.,, V. J. Schnadig, and, M. R. McGinnis. 1998. Chlamydoconidia formation in zygomycosis due to Rhizopus species. Arch. Pathol. Lab. Med. 122:11201122.
198. Kimura, M.,, M. B. Smith, and, M. R. McGinnis. 1999. Zygomycosis due to Apophysomyces elegans: report of 2 cases and review of the literature. Arch. Pathol. Lab. Med. 123:386390.
199. King, D. S., and, S. C. Jong. 1976. Identity of the etiological agent of the first deep entomophthoraceous infection of man in the United States. Mycologia 68:181183.
200. Kitabayashi, A.,, M. Hirokawa,, A. Yamaguchi,, H. Takatsu, and, A. B. Miura. 1998. Invasive pulmonary mucormycosis with rupture of the thoracic aorta. Am. J. Hematol. 58:326329.
201. Kline, M. W., 1985. Mucormycosis in children: review of the literature and report of cases. Pediatr. Infect. Dis. 4:672676.
202. Kolbeck, P. C.,, R. G. Makhoul,, R. R. Bollinger, and, F. Sanfilippo. 1985. Widely disseminated Cunninghamella mucormycosis in an adult renal transplant patient: case report and review of the literature. Am. J. Clin. Pathol. 83:747753.
203. Kontoyiannis, D. P.,, M. S. Lionakis,, R. E. Lewis,, G. Chamilos,, M. Healy,, C. Perego,, A. Safdar,, H. Kantarjian,, R. Champlin,, T. J. Walsh, and, I. I. Raad. 2005. Zygomycosis in a tertiary-care cancer center in the era of Aspergillus-active antifungal therapy: a case-control observational study of 27 recent cases. J. Infect. Dis. 191:13501360.
204. Kontoyiannis, D. P.,, V. C. Wessel,, G. P. Bodey, and, K. V. Rolston. 2000. Zygomycosis in the 1990s in a tertiary-care cancer center. Clin. Infect. Dis. 30:851856.
205. Kramer, B. S.,, A. D. Hernandez,, R. L. Reddick, and, A. S. Levine. 1977. Cutaneous infarction. Manifestation of disseminated mucormycosis. Arch. Dermatol. 113:10751076.
206. Krasinski, K.,, R. S. Holzman,, B. Hanna,, M. A. Greco,, M. Graff, and, M. Bhogal. 1985. Nosocomial fungal infection during hospital renovation. Infect. Control 6:278282.
207. Kwon-Chung, J. K., and, J. E. Bennett. 1992. Mucormycosis (physomycosis, zygomycosis), p. 524559. In K. J. Kwon-Chung and, J. E. Bennett (ed.), Medical Mycology. Lea & Febiger, Philadelphia, Pa.
208. Kwon-Chung, K. J.,, R. C. Young, and, M. Orlando. 1975. Pulmonary mucormycosis caused by Cunning-hamella elegans in a patient with chronic myelogenous leukemia. Am. J. Clin. Pathol. 64:544548.
209. Lake, F. R.,, R. McAleer, and, A. E. Tribe. 1988. Pulmonary mucormycosis without underlying systemic disease. Med. J. Aust. 149:323326.
210. Lakshmi, V.,, T. S. Rani,, S. Sharma,, V. S. Mohan,, C. Sundaram,, R. R. Rao, and, G. Satyanarayana. 1993. Zygomycotic necrotizing fasciitis caused by Apophysomyces elegans. J. Clin. Microbiol. 31:13681369.
211. Langford, J. D.,, D. L. McCartney, and, R. C. Wang. 1997. Frozen section-guided surgical debridement for management of rhino-orbital mucormycosis. Am. J. Ophthalmol. 124:265267.
212. Langston, C.,, D. A. Roberts,, G. A. Porter, and, W. M. Bennett. 1973. Renal phycomycosis. J. Urol. 109:941944.
213. Latif, S.,, N. Saffarian,, K. Bellovich, and, R. Provenzano. 1997. Pulmonary mucormycosis in diabetic renal allograft recipients. Am. J. Kidney Dis. 29:461464.
214. Lawson, H. H., and, A. Schmaman. 1974. Gastric phycomycosis. Br. J. Surg. 61:743746.
215. Lazo, A.,, H. I. Wilner, and, J. J. Metes. 1981. Craniofacial mucormycosis: computed tomographic and angiographic findings in two cases. Radiology 139:623626.
216. Lee, E.,, Y. Vershvovsky,, F. Miller,, W. Waltzer,, H. Suh, and, E. P. Nord. 2001. Combined medical surgical therapy for pulmonary mucormycosis in a diabetic renal allograft recipient. Am. J. Kidney Dis. 38:e37.
217. Lee, F. Y.,, S. B. Mossad, and, K. A. Adal. 1999. Pulmonary mucormycosis: the last 30 years. Arch. Intern. Med. 159:13011309.
218. Leeming, J. G.,, H. A. Moss, and, T. S. Elliott. 1996. Risk of tongue depressors to the immunocompromised. Lancet 348:889.
219. Lehrer, R. I., 1980. Mucormycosis (UCL conference). Ann. Intern. Med. 93:93108.
220. Leleu, X.,, B. Sendid,, J. Fruit,, H. Sarre,, E. Wattel,, C. Rose,, F. Bauters,, T. Facon, and, J. Jouet. 1999. Combined anti-fungal therapy and surgical resection as treatment of pulmonary zygomycosis in allogeneic bone marrow transplantation. Bone Marrow Transplant. 24:417420.
221. Leong, K. W.,, B. Crowley,, B. White,, G. M. Crotty,, D. S. O’Briain,, C. Keane, and, S. R. McCann. 1997. Cutaneous mucormycosis due to Absidia corymbifera occurring after bone marrow transplantation. Bone Marrow Transplant. 19:513515.
222. Levitz, S. M.,, M. E. Selsted,, T. Ganz,, R. I. Lehrer, and, R. D. Diamond. 1986. In vitro killing of spores and hyphae of Aspergillus fumigatus and Rhizopus oryzae by rabbit neutrophil cationic peptides and bronchoalveolar macrophages. J. Infect. Dis. 154:483489.
223. Levy, V.,, B. Rio,, A. Bazarbachi,, M. Hunault,, A. Delmer,, R. Zittoun,, V. Blanc, and, M. Wolff. 1996. Two cases of epidemic mucormycosis infection in patients with acute lymphoblastic leukemia. Am. J. Hematol. 52:6465.
224. Lewis, L. L.,, H. K. Hawkins, and, M. S. Edwards. 1990. Disseminated mucormycosis in an infant with methylmalonicaciduria. Pediatr. Infect. Dis. J. 9:851854.
225. Lidor, C., and, J. A. Nunley. 1997. Images in clinical medicine. Mucormycosis of the hand and forearm. N. Engl. J. Med. 337:1511.
226. Liles, W. C.,, J. E. Huang,, J. A. van Burik,, R. A. Bowden, and, D. C. Dale. 1997. Granulocyte colony-stimulating factor administered in vivo augments neutrophil-mediated activity against opportunistic fungal pathogens. J. Infect. Dis. 175:10121015.
227. Linden, P.,, P. Williams, and, K. M. Chan. 2000. Efficacy and safety of amphotericin B lipid complex injection (ABLC) in solid-organ transplant recipients with invasive fungal infections. Clin. Transplant. 14:329339.
228. Liu, M. F.,, F. F. Chen,, T. R. Hsiue, and, C. C. Liu. 2000. Disseminated zygomycosis simulating cerebrovascular disease and pulmonary alveolar haemorrhage in a patient with systemic lupus erythematosus. Clin. Rheumatol. 19:311314.
229. Loevner, L. A.,, J. C. Andrews, and, I. R. Francis. 1992. Multiple mycotic pulmonary artery aneurysms: a complication of invasive mucormycosis. Am. J. Roentgenol. 158:761762.
230. Lopes, J. O.,, D. V. Pereira,, L. A. Streher,, A. A. Fenalte,, S. H. Alves, and, J. P. Benevenga. 1995. Cutaneous zygomycosis caused by Absidia corymbifera in a leukemic patient. Mycopathologia 130:8992.
231. Lowe, J. T., Jr., and, W. R. Hudson. 1975. Rhinocerebral phycomycosis and internal carotid artery thrombosis. Arch. Otolaryngol. 101:100103.
232. Lueg, E. A.,, R. H. Ballagh, and, V. Forte. 1996. Analysis of the recent cluster of invasive fungal sinusitis at the Toronto Hospital for Sick Children. J. Otolaryngol. 25:366370.
233. Lussier, N.,, M. Laverdiere,, K. Weiss,, L. Poirier, and, E. Schick. 1998. Primary renal mucormycosis. Urology 52:900903.
234. Mackenzie, D. W.,, J. F. Soothill, and, J. H. Millar. 1988. Meningitis caused by Absidia corymbifera. J. Infect. 17:241248.
235. MacMillan, M. L.,, J. L. Goodman,, T. E. DeFor, and, D. J. Weisdorf. 2002. Fluconazole to prevent yeast infections in bone marrow transplantation patients: a randomized trial of high versus reduced dose, and determination of the value of maintenance therapy. Am. J. Med. 112:369379.
236. Maertens, J.,, H. Demuynck,, E. K. Verbeken,, P. Zachee,, G. E. Verhoef,, P. Vandenberghe, and, M. A. Boogaerts. 1999. Mucormycosis in allogeneic bone marrow transplant recipients: report of five cases and review of the role of iron overload in the pathogenesis. Bone Marrow Transplant. 24:307312.
237. Mamlok, V.,, W. T. Cowan, Jr., and, V. Schnadig. 1987. Unusual histopathology of mucormycosis in acute myelogenous leukemia. Am. J. Clin. Pathol. 88:117120.
238. Marr, K. A.,, R. A. Carter,, F. Crippa,, A. Wald, and, L. Corey. 2002. Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin. Infect. Dis. 34:909917.
239. Marr, T. J.,, H. S. Traismann,, A. T. Davis, and, D. Kernahan. 1978. Rhinocerebral mucormycosis and juvenile diabetes mellitus: report of a case with recovery. Diabetes Care 1:250251.
240. Marshall, D. H.,, S. Brownstein,, W. B. Jackson,, G. Mintsioulis,, S. M. Gilberg, and, B. F. al-Zeerah. 1997. Post-traumatic corneal mucormycosis caused by Absidia corymbifera. Ophthalmology 104:11071111.
241. Martinez, E. J.,, M. R. Cancio,, J. T. T. Sinnott,, A. L. Vincent, and, S. G. Brantley. 1997. Nonfatal gastric mucormycosis in a renal transplant recipient. South. Med. J. 90:341344.
242. Marty, F. M.,, L. A. Cosimi, and, L. R. Baden. 2004. Breakthrough zygomycosis after voriconazole treatment in recipients of hematopoietic stem-cell transplants. N. Engl. J. Med. 350:950952.
243. Mathew, R.,, S. Kumaravel,, S. Kuruvilla,, R. G. Varghese,, Shashikala,, S. Srinivasan, and, M. Z. Mani. 2005. Successful treatment of extensive basidiobolomycosis with oral itraconazole in a child. Int. J. Dermatol. 44:572575.
244. Mathews, M. S.,, A. Raman, and, A. Nair. 1997. Nosocomial zygomycotic post-surgical necrotizing fasciitis in a healthy adult caused by Apophysomyces elegans in south India. J. Med. Vet. Mycol. 35:6163.
245. Matsushima, T.,, R. Soejima, and, T. Nakashima. 1980. Solitary pulmonary nodule caused by phycomycosis in a patient without obvious predisposing factors. Thorax 35:877878.
246. Maury, S.,, T. Leblanc,, M. Feuilhade,, J. M. Molina, and, G. Schaison. 1998. Successful treatment of disseminated mucormycosis with liposomal amphotericin B and surgery in a child with leukemia. Clin. Infect. Dis. 26:200202.
247. Mayer, P.,, E. Schutze,, C. Lam,, F. Kricek, and, E. Liehl. 1991. Recombinant murine granulocyte-macrophage colony-stimulating factor augments neutrophil recovery and enhances resistance to infections in myelosuppressed mice. J. Infect. Dis. 163:584590.
248. Mazade, M. A.,, J. F. Margolin,, S. N. Rossmann, and, M. S. Edwards. 1998. Survival from pulmonary infection with Cunninghamella bertholletiae: case report and review of the literature. Pediatr. Infect. Dis. J. 17:835839.
249. McAdams, H. P.,, M. Rosado de Christenson,, D. C. Strollo, and, E. F. Patz, Jr., 1997. Pulmonary mucormycosis: radiologic findings in 32 cases. Am. J. Roentgenol. 168:15411548.
250. McNulty, J. S., 1982. Rhinocerebral mucormycosis: predisposing factors. Laryngoscope 92:11401143.
251. Mead, J. H.,, G. P. Lupton,, C. L. Dillavou, and, R. B. Odom. 1979. Cutaneous Rhizopus infection. Occurrence as a postoperative complication associated with an elasticized adhesive dressing. JAMA 242:272274.