Intra‐arterial spread of <i>Mucormycetes</i> mediates early ischemic necrosis of brain and suggests new venues for prophylactic therapy

Bannykh, Sergei I.; Hunt, Brice; Moser, Franklin G.

doi:10.1111/neup.12501

Cited by 9 publications

(7 citation statements)

References 8 publications

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“…After the entry of the fungus, the invasion occurs either via hematogenous spread or by direct cranial dispersion from the paranasal sinuses. Patients who have diabetes mellitus as a major co-morbidity for mucormycosis, the CNS becomes the third most common site of infection ( Bannykh et al, 2018 ; Higo et al, 2015 ). The fungal hypha develops in the internal elastic lamina and spreads to the arterial lumen, eradicating intravascular thrombosis.…”

Section: Depletion Of Organs Due To Mucormycosismentioning

confidence: 99%

Mucormycosis: An opportunistic pathogen during COVID-19

Iyer¹,

Jayaramayya

Venkatesan

et al. 2021

Environmental Research

161

122

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The pandemic of coronavirus disease 2019 (COVID-19) still remains on an upsurge trend. The second wave of this disease has led to panic in many countries, including India and some parts of the world suffering from the third wave. As there are no proper treatment options or remedies available for this deadly infection, supportive care equipment's such as oxygen cylinders, ventilators and heavy use of steroids play a vital role in the management of COVID-19. In the midst of this pandemic, the COVID-19 patients are acquiring secondary infections such as mucormycosis also known as black fungus disease. Mucormycosis is a serious, but rare opportunistic fungal infection that spreads rapidly, and hence prompt diagnosis and treatment are necessary to avoid high rate of mortality and morbidity rates. Mucormycosis is caused by the inhalation of its filamentous (hyphal form) fungi especially in the patients who are immunosuppressed. Recent studies have documented alarming number of COVID-19 patients with mucormycosis infection. Most of these patients had diabetes and were administered steroids for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and were consequently more prone to mucormycosis. Hence, the present review emphasizes mucormycosis and its related conditions, its mechanism in normal and COVID-19 affected individuals, influencing factors and challenges to overcome this black mold infection. Early identification and further investigation of this fungus will significantly reduce the severity of the disease and mortality rate in COVID-19 affected patients.

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Section: Depletion Of Organs Due To Mucormycosismentioning

confidence: 99%

Mucormycosis: An opportunistic pathogen during COVID-19

Iyer¹,

Jayaramayya

Venkatesan

et al. 2021

Environmental Research

161

122

View full text Add to dashboard Cite

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“…Autopsy studies show that for all three routes, Mucorales enter the brain by way of the cerebral vascular system [11]. Fungal hyphae grow along the internal elastic lamina and extend into the arterial lumen, which becomes obliterated with intravascular thrombosis and intimal hyperplasia [11,13]. Vascular occlusion leads to cerebral infarction and hemorrhagic necrosis, initially without hyphal invasion of brain tissue [11,12,13].…”

Section: Pathogenesismentioning

confidence: 99%

“…Fungal hyphae grow along the internal elastic lamina and extend into the arterial lumen, which becomes obliterated with intravascular thrombosis and intimal hyperplasia [11,13]. Vascular occlusion leads to cerebral infarction and hemorrhagic necrosis, initially without hyphal invasion of brain tissue [11,12,13]. This necrotic hypoxemic environment likely impairs both host innate immune cells and antifungal drugs from accessing and acting on Mucorales.…”

Section: Pathogenesismentioning

confidence: 99%

“…Thus, patients with diabetes mellitus usually develop rhino-orbital-cerebral mucormycosis (ROCM), patients with hematological neoplasms tend to develop sino-pulmonary disease, and trauma patients present with necrotizing skin and soft tissue infections [8,9]. In all anatomical locations, relentless tissue invasion and infarction secondary to angioinvasion are the hallmarks of mucormycosis [10,11,12,13].…”

Section: Introductionmentioning

confidence: 99%

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Mucormycosis of the Central Nervous System

Chikley

Ben‐Ami

Kontoyiannis

2019

JoF

104

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Mucormycosis involves the central nervous system by direct extension from infected paranasal sinuses or hematogenous dissemination from the lungs. Incidence rates of this rare disease seem to be rising, with a shift from the rhino-orbital-cerebral syndrome typical of patients with diabetes mellitus and ketoacidosis, to disseminated disease in patients with hematological malignancies. We present our current understanding of the pathobiology, clinical features, and diagnostic and treatment strategies of cerebral mucormycosis. Despite advances in imaging and the availability of novel drugs, cerebral mucormycosis continues to be associated with high rates of death and disability. Emerging molecular diagnostics, advances in experimental systems and the establishment of large patient registries are key components of ongoing efforts to provide a timely diagnosis and effective treatment to patients with cerebral mucormycosis.

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“…Due to the invasion of blood vascular system, especially internal elastic arterial lamina, by hyphae and high tropism, dissection and thrombosis occur [3,10,12]. At first, without the invasion of the brain tissue by hyphae, vascular occlusion occurs, which causes hemorrhagic necrosis and cerebral infarction [3,16–18]. Then, in a necrotic situation, hypoxia occurs, which results in the dysfunction of both innate and adaptive immune systems and could reduce the effect of antifungal drugs.…”

Section: Invasionmentioning

confidence: 99%

A closer look at pathogenesis of cerebral mucormycosis in diabetic condition: A mini review

et al. 2021

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Patients with diabetes are considered a high‐risk group involved with cerebral mucormycosis (CM). Due to the potential of Mucorales to invade sinuses and its rapid progression into orbit and retro‐orbital areas and even brain, in most cases, CM is fatal in patients with diabetes. In the last few decades, mucormycosis and background conditions responsible for the development of its infections have received a great deal of attention. Dysfunction of innate and adaptive immune system, the increased amount of available nutrition, expression of host factors, and free iron level in plasma in diabetic ketoacidosis are among the topics that have been mostly taken into account so far. Therefore, it is important to clarify the molecular mechanisms that let the Mucorales to involve the patients with diabetes, which even at early stages of diagnosis and treatment, there is minimum chance to control the disease.

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Intra‐arterial spread of Mucormycetes mediates early ischemic necrosis of brain and suggests new venues for prophylactic therapy

Cited by 9 publications

References 8 publications

Mucormycosis: An opportunistic pathogen during COVID-19

Mucormycosis: An opportunistic pathogen during COVID-19

Mucormycosis of the Central Nervous System

A closer look at pathogenesis of cerebral mucormycosis in diabetic condition: A mini review

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