What is Hyperbaric Zygomycotic Infections (Hyperbaric Mucormycosis Infections)?
Invasive zygomycosis, also known as mucormycosis, is a type of infection caused by a group of fungi called Mucorales. The infection often comes from a kind of fungi known as Rhizopus from the Mucoraceae family. The infection is very aggressive, often deadly, even when treated appropriately. This disease is very rare in healthy individuals and mostly affects people with weak immune systems. Specifically, those with diabetes experiencing ketoacidosis – a dangerous condition that makes the blood more acidic – are at high risk, as the acidic environment promotes the growth of the fungi.
What Causes Hyperbaric Zygomycotic Infections (Hyperbaric Mucormycosis Infections)?
These microorganisms are found everywhere. They exist outdoors in soil and plant life. Interestingly, they are also a typical type of mold found in homes. According to a Denmark study, it was found in 98% of dust samples from households. Further research has also discovered this mold in molded bread, various other foods, unclean carpets, and vacuum cleaner systems.
Risk Factors and Frequency for Hyperbaric Zygomycotic Infections (Hyperbaric Mucormycosis Infections)
Zygomycotic infections, which are aggressive in nature, typically affect people who have a compromised immune system. They commonly afflict individuals with uncontrolled diabetes, particularly those dealing with a condition known as ketoacidosis. People with cancers, blood disorders, transplants, burns or those taking medications that suppress their immune system are also at risk. For unknown reasons, two-thirds of these zygomycotic infections occur in males. Regardless of race, age, or location, the occurrence of zygomycotic infections is equally distributed.
Signs and Symptoms of Hyperbaric Zygomycotic Infections (Hyperbaric Mucormycosis Infections)
Zygomycosis is a fungal infection that can manifest in several different ways, including affecting the nose and brain (rhinocerebral), lungs (pulmonary), digestive tract (gastrointestinal), skin (cutaneous), or spreading throughout the body (disseminated). The rhinocerebral type is the most common and it initially resembles a sinus infection, with symptoms such as nasal congestion, sinus pain, and a runny nose. As it advances, the symptoms can increase to include redness, swelling around the eyes, and black, necrotic (dead) tissues. Other symptoms may depend on the individual’s health condition, such as people with diabetic ketoacidosis, who might experience symptoms like nausea, vomiting, and abdominal pain.
- Nose and brain infection (rhinocerebral)
- Lung infection (pulmonary)
- Digestive tract infection (gastrointestinal)
- Skin infection (cutaneous)
- Spread throughout the body (disseminated)
- Sinusitis-like symptoms (for rhinocerebral type)
- Redness, swelling around the eyes, black necrotic tissues (as infection advances)
- Other symptoms depending on the individual’s health condition
Treatment Options for Hyperbaric Zygomycotic Infections (Hyperbaric Mucormycosis Infections)
The current recommended treatment for this condition includes extensive surgical cleaning and treatment with a specific medication called liposomal amphotericin B. If there’s any suspicion of this condition, treatment should start straight away. It’s also important to manage any related health issues, such as uncontrolled diabetes, as part of the treatment plan.
Hyperbaric oxygen therapy (HBO) is another treatment option that’s often used for serious skin infections, long-lasting bone infections, and skin grafts that aren’t healing well. Essentially, this therapy involves breathing pure oxygen in a pressurized room or tube, enabling your blood to carry more oxygen to your organs and tissues. This can help tissues that aren’t healing due to lack of oxygen. Moreover, HBO therapy can stimulate the growth of new blood vessels, which can be beneficial considering how this condition invades and affects blood vessels. After extensive surgery, this therapy might also improve the healing of bone and granulation tissue, which is new connective tissue and tiny blood vessels that form on the surfaces of a wound during the healing process.
However, as this is a rare and severe infection, it’s challenging to carry out clinical trials that involve a large number of patients. The research on using HBO therapy primarily relies on case reports and past studies. In one literature review, they found that out of 12 patients treated with surgery and medication, those who also got HBO therapy had a higher survival rate. However, this sample size is too small to make any conclusive claims.
In another noteworthy case study, two very ill patients with serious brain abscesses were treated with HBO therapy. Despite the advancement of their condition and having undergone surgical cleaning, their infection kept getting worse until HBO therapy was added to their treatment plan. They both showed noticeable improvements, remaining disease-free 21 months after being discharged.
Based on the nature of the disease, its high risk of complications or death, and the benefits of HBO treatment, it seems reasonable to consider HBO as supplementary therapy in treating this condition.
What else can Hyperbaric Zygomycotic Infections (Hyperbaric Mucormycosis Infections) be?
Here are some medical conditions that should be considered:
- Actinomycosis
- Anthrax
- Aspergillosis
- Brain abscess
- Cryptococcosis
- Cellulitis
- Colonic obstruction
- Ecthyma gangrenosum
- Fusariosis
- Nocardiosis
What to expect with Hyperbaric Zygomycotic Infections (Hyperbaric Mucormycosis Infections)
Even when treated quickly and correctly, approximately one in two people do not survive this disease. Rhino-orbital-cerebral mucormycosis, a particular type of the disease, has an even higher death rate, as reported by some studies, which could range between 30% to 80%, depending on the underlying health issue.
The likelihood of survival tends to be lower in individuals who have blood disorders or cancer because these underlying conditions are more challenging to treat. If the disease spreads throughout the body, the death rate increases drastically to more than 90%.
For the patients who manage to survive, they often have to deal with physical scarring or other lasting effects caused by the extensive surgical procedures done to remove diseased areas.