title: Mucormycosis in Mato Grosso, Brazil: a case reports, caused by Rhizopus microsporus var. oligosporus and Rhizopus microsporus var. rhizopodiformis.
abstract: We identified the etiological agents responsible for two fatal cases of rhinocerebral mucormycosis with the classical risk factor for uncontrolled type II diabetes mellitus. Their initial symptoms did not point immediately to the suspicion of mucormycosis. Case 1, caused by Rhizopus microsporus var. oligosporus, was a 52-year-old man who presented with a painful pimple on his nose, which evolved with swelling, erythema, and a central pustule on his right hemiface suspected to be cellulitis. After 7 days of antibiotic treatment, the patient worsened with signs of sepsis and the lesion evolved to necrosis involving all his right face. Case 2, caused by Rhizopus microsporus var. rhizopodiformis, was a 57-year-old woman placed on continuous therapy with azathioprine and corticoids after a renal transplant due to chronic arterial hypertension and uncontrolled type II diabetes mellitus. Because she was suspected to have sepsis, the patient was treated with broad-spectrum antibiotics and mechanical ventilation, yet she deteriorated. Because Candida spp. were isolated from urine and a BAL, she was treated with fluconazole for 10 days, then substituted by caspofungin. Two weeks later, she presented with exophthalmus of the left eye that was surrounded by a large inflammatory and necrotic area. Both patients were the diagnosed with mucormycosis via direct microscopy of necrotic material prior to their death.
authors.affiliation: Mycology Laboratory, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.
authors.forename: Luciano Corrêa
authors.initials: LC
authors.lastname: Ribeiro
authors.forename: Bodo
authors.initials: B
authors.lastname: Wanke
authors.forename: Manuela
authors.initials: M
authors.lastname: da Silva
authors.forename: Luciana Basili
authors.initials: LB
authors.lastname: Dias
authors.forename: Renato
authors.initials: R
authors.lastname: Mello
authors.forename: Fernando Artur Pena Borges
authors.initials: FA
authors.lastname: Canavarros
authors.forename: Diniz Pereira
authors.initials: DP
authors.lastname: Leite
authors.forename: Rosane Christine
authors.initials: RC
authors.lastname: Hahn
mesh_terms: D001938:Brazil; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000382:microbiology*; D012233:Rhizopus / Q000302:isolation & purification*