Zygomycetes

The Mucoraceae are in the Zygomycetes class and cause the disease mucormycosis. This disorder is typically an acute fulminant CNS infection that occurs primarily in immunocompetent patients with ketoacidosis and in diabetic transplant recipients receiving immunosuppressive agents. The infection tends to originate in the palate or paranasal sinuses and spreads through the orbits and paranasal sinuses into the brain. The infection is often manifest by a black eschar on the palate or nasal mucosa with a blackish purulent discharge from the involved areas. Examination of the CSF demonstrates an elevated opening pressure, a pleocytosis with a predominance of polymorphonuclear cells, a normal glucose concentration, and an elevated protein concentration. Diagnosis is made by a biopsy of the black eschar.'^ The treatment of CNS mucormycosis involves debridement of all devitalized tissues and high-dose amphotericin B (1.0 mg/kg/d). [115]

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