title: Epidemiology and Clinical Characteristics of Mucormycosis in Patients with Leukemia; A 21-year Experience from Southern Iran.
abstract: OBJECTIVE
  To determine the epidemiological aspect of mucormycosis, the nature of malignancies complicated by mucormycosis, the initial site of involvement and the subsequent outcome.
  
  
  METHODS
  This was a cross-sectional study which was performed by reviewing the medical records of 95 patients with leukemia complicated with biopsy-proven mucormycosis admitted to the educational hospitals affiliated with Shiraz University of Medical Sciences over a 21-year period. We recorded demographic information including age and sex and disease characteristics such as type of leukemia, site of involvement, paraclinical findings at the time of admission and the outcome of the patients. The incidence of mucormycosis in leukemia was determined by identifying the number of leukemia patients diagnosed within the last 17 years.
  
  
  RESULTS
  The male to female ratio was 2.39:1 in of 95 patients studied. The overall incidence rate of mucormycosis was 4.27 per 100 leukemic patients in last 17 years which showed a decreasing trend from 2001 to 2011. The most frequent type of leukemia was acute myelogenous leukemia (AML) which was found in 58 patients (61.5%). The most common site of initial tumor involvement was sinonasal (90.16%). The mortality rate was about 54%, compared to the mortality rate of about 43.24% in patients with best prognosis of AML.
  
  
  CONCLUSIONS
  The incidence of mucormycosis in leukemia showed a decreasing trend in our country and its recent incidence is comparable to that of other regions. The best preventive method against this lethal infection is to modify and control the environment which reduces the risk of exposure to air-born fungal spores.
authors.affiliation: Department of Surgery, Imam-Ali Education Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Amene
authors.initials: A
authors.lastname: S Sarvestani
authors.affiliation: Department of Internal Medicine, Endocrinology  and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Pishdad
authors.affiliation: Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Bolandparvaz
keywords: Iran; Leukemia; Mucormycosis