Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
Clin Microbiol Rev. 2011 Apr;24(2):411-45. doi: 10.1128/CMR.00056-10.
Rhizopus, Mucor, and Lichtheimia (formerly Absidia) species are the most common members of the order Mucorales that cause mucormycosis, accounting for 70 to 80% of all cases. In contrast, Cunninghamella, Apophysomyces, Saksenaea, Rhizomucor, Cokeromyces, Actinomucor, and Syncephalastrum species individually are responsible for fewer than 1 to 5% of reported cases of mucormycosis. In this review, we provide an overview of the epidemiology, clinical manifestations, diagnosis of, treatment of, and prognosis for unusual Mucormycetes infections (non-Rhizopus, -Mucor, and -Lichtheimia species). The infections caused by these less frequent members of the order Mucorales frequently differ in their epidemiology, geographic distribution, and disease manifestations. Cunninghamella bertholletiae and Rhizomucor pusillus affect primarily immunocompromised hosts, mostly resulting from spore inhalation, causing pulmonary and disseminated infections with high mortality rates. R. pusillus infections are nosocomial or health care related in a large proportion of cases. While Apophysomyces elegans and Saksenaea vasiformis are occasionally responsible for infections in immunocompromised individuals, most cases are encountered in immunocompetent individuals as a result of trauma, leading to soft tissue infections with relatively low mortality rates. Increased knowledge of the epidemiology and clinical presentations of these unusual Mucormycetes infections may improve early diagnosis and treatment.
根霉属、毛霉属和亮菌属（以前称为犁头霉属）是引起毛霉病的最常见的 Mucorales 目成员，占所有病例的 70%至 80%。相比之下， Cunninghamella、Apophysomyces、Saksenaea、Rhizomucor、Cokeromyces、Actinomucor、Syncephalastrum 属各自导致的毛霉病报告病例少于 1%至 5%。在这篇综述中，我们概述了罕见的毛霉属（非根霉属、毛霉属和亮菌属）感染的流行病学、临床表现、诊断、治疗和预后。这些较少见的 Mucorales 目成员引起的感染在流行病学、地理分布和疾病表现方面经常存在差异。Cunninghamella bertholletiae 和 Rhizomucor pusillus 主要影响免疫功能低下的宿主，主要通过孢子吸入引起肺部和播散性感染，死亡率很高。R. pusillus 感染在很大比例的病例中是医院获得性或与医疗保健相关的。虽然 Apophysomyces elegans 和 Saksenaea vasiformis 偶尔会导致免疫功能低下个体的感染，但大多数情况下是由于创伤导致免疫功能正常的个体发生软组织感染，死亡率相对较低。增加对这些罕见毛霉属感染的流行病学和临床表现的了解可能会改善早期诊断和治疗。
