Recommendations for antifungal therapy of mucormycosis from the Huaxi Mucormycosis Collaboration Network_West China Medical Journal

Authors：

QUAN Min ¹ , LIU Xinyao ² ,  QU Junyan ¹ , GUO Xiaopan ² , KANG Mei ³ , GUAN Mei ⁴ , LIU Yongfang ⁵ , GENG Xiaoxia ⁶ , ZHANG Quan ⁷ , MA Ke ⁷ , CHEN Xuebing ⁸ , YANG Qing ⁹ , ZHOU Jie ¹⁰ , LUO Ling ^11,12 , YANG Yuan ¹³ , WANG Qujue ¹⁴ , TANG Jing ¹⁵ , ZHOU Xue ¹⁶ , YAN Ke ¹⁷ , DENG Hui ¹⁸ , YUAN Wenli ¹⁹ , ZHU Tao ²⁰ , XIANG Yongsheng ²¹ , LONG Zhiling ²² ,  ZONG Zhiyong ^1,2

1. Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Laboratory of Pathogen Research, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
4. Department of Clinical Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
5. Department of Infectious Diseases, the Third People’s Hospital of Chengdu, Chengdu, Sichuan 610014, P. R. China;
6. Geriatric Infectious Diseases Department, Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;
7. Department of Infectious Diseases, the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 550004, P. R. China;
8. Department of Infectious Diseases, Deyang People’s Hospital, Deyang, Sichuan 618000, P. R. China;
9. Department of Hematology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China;
10. Department of Hematology, Deyang People’s Hospital, Deyang, Sichuan 618000, P. R. China;
11. General Internal Medicine, Chongqing University Cancer Hospital, Chongqing 400030, P. R. China;
12. Key Laboratory of Chongqing Education Commission of China for Cancer Digital Precision Radiotherapy, Chongqing 400030, P. R. China;
13. Department of Infectious Diseases, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, P. R. China;
14. Department of Infectious Diseases, Renshou County People’s Hospital, Meishan, Sichuan 620599, P. R. China;
15. Department of Infectious Diseases, Ziyang Central Hospital, Ziyang, Sichuan 641399, P. R. China;
16. Department of Infectious Diseases, Mianzhu People’s Hospital, Mianzhu, Sichuan 618200, P. R. China;
17. Department of Infectious Diseases, Guang’an People’s Hospital, Guang’an, Sichuan 638000, P. R. China;
18. Department of Infectious Diseases, Meishan People’s Hospital, Meishan, Sichuan 620010, P. R. China;
19. Clinical Laboratory, the Second People’s Hospital of Yunnan Province, Kunming, Yunnan 650021, P. R. China;
20. Department of Respiratory and Critical Care Medicine, Suining Central Hospital, Suining, Sichuan 629000, P. R. China;
21. Department of Hematology, Panzhihua Central Hospital, Panzhihua, Sichuan 617067, P. R. China;
22. Department of Infectious Diseases, Ya’an People’s Hospital, Ya’an, Sichuan 625000, P. R. China;

Corresponding?author：

QU Junyan, Email: qujunyan15647@wchscu.cn; ZONG Zhiyong, Email: zongzhiy@scu.edu.cn

Keywords：

Mucormycosis; Mucorales; therapy; amphotericin B; surgery; practical recommendations

DOI：

10.7507/1002-0179.202602130

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

This article explores the treatment principles of mucormycosis within the framework of international guidelines, systematically reviews the treatment strategies for different clinical types and special populations, as well as the application of surgical and local interventions in different types of mucormycosis, by integrating differences in host status, etiological characteristics, and infection sites of mucormycosis, and referencing the practical experience of hospitals in the Huaxi Mucormycosis Collaboration Network in the diagnosis and treatment of mucormycosis. The aim is to provide reference and guidance for clinical decision-making.

Citation： QUAN Min, LIU Xinyao, QU Junyan, GUO Xiaopan, KANG Mei, GUAN Mei, LIU Yongfang, GENG Xiaoxia, ZHANG Quan, MA Ke, CHEN Xuebing, YANG Qing, ZHOU Jie, LUO Ling, YANG Yuan, WANG Qujue, TANG Jing, ZHOU Xue, YAN Ke, DENG Hui, YUAN Wenli, ZHU Tao, XIANG Yongsheng, LONG Zhiling, ZONG Zhiyong. Recommendations for antifungal therapy of mucormycosis from the Huaxi Mucormycosis Collaboration Network. West China Medical Journal, 2026, 41(3): 375-384. doi: 10.7507/1002-0179.202602130 Copy

1.	Patel A, Agarwal R, Rudramurthy SM, et al. Multicenter epidemiologic study of coronavirus disease-associated mucormycosis, India. Emerg Infect Dis, 2021, 27(9): 2349-2359.
2.	Muthukumarasamy N, Suzuki H. Longitudinal epidemiology of mucormycosis within the veterans health administration: a retrospective cohort study over a 20-year period. Mycoses, 2024, 67(9): e13794.
3.	Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis, 2005, 41(5): 634-653.
4.	Gouzien L, Che D, Cassaing S, et al. Epidemiology and prognostic factors of mucormycosis in France (2012-2022): a cross-sectional study nested in a prospective surveillance programme. Lancet Reg Health Eur, 2024, 45: 101010.
5.	Chamilos G, Lewis RE, Kontoyiannis DP. Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin Infect Dis, 2008, 47(4): 503-509.
6.	Chakrabarti A, Das A, Mandal J, et al. The rising trend of invasive zygomycosis in patients with uncontrolled diabetes mellitus. Med Mycol, 2006, 44(4): 335-342.
7.	Skiada A, Pavleas I, Drogari-Apiranthitou M. Epidemiological trends of mucormycosis in europe, comparison with other continents. Mycopathologia, 2024, 189(6): 100.
8.	Alastruey-Izquierdo A, Castelli MV, Cuesta I, et al. In vitro activity of antifungals against zygomycetes. Clin Microbiol Infect, 2009, 15(Suppl 5): 71-76.
9.	Pastor FJ, Ruíz-Cendoya M, Pujol I, et al. In vitro and in vivo antifungal susceptibilities of the mucoralean fungus Cunninghamella. Antimicrob Agents Chemother, 2010, 54(11): 4550-4555.
10.	Salas V, Pastor FJ, Calvo E, et al. In vitro and in vivo activities of posaconazole and amphotericin B in a murine invasive infection by mucor circinelloides: poor efficacy of posaconazole. Antimicrob Agents Chemother, 2012, 56(5): 2246-2250.
11.	Cornely OA, Alastruey-Izquierdo A, Arenz D, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis, 2019, 19(12): e405-e421.
12.	Neblett Fanfair R, Benedict K, Bos J, et al. Necrotizing cutaneous mucormycosis after a tornado in Joplin, Missouri, in 2011. N Engl J Med, 2012, 367(23): 2214-2225.
13.	Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev, 2005, 18(3): 556-569.
14.	Badali H, Ca?ete-Gibas C, McCarthy D, et al. Epidemiology and antifungal susceptibilities of mucoralean fungi in clinical samples from the United States. J Clin Microbiol, 2021, 59(9): e0123021.
15.	Borman AM, Fraser M, Patterson Z, et al. In vitro antifungal drug resistance profiles of clinically relevant members of the Mucorales (mucoromycota) especially with the newer triazoles. J Fungi (Basel), 2021, 7(4): 271.
16.	Escribano P, Mesquida A, López-Montesinos S, et al. Amphotericin B, itraconazole, posaconazole, and isavuconazole MICs against clinical Mucorales isolates obtained by visual inspection and spectrophotometric reading according to the EUCAST 9. 4 procedure. Med Mycol, 2023, 61(5): myad045.
17.	Clinical and Laboratory Standards Institute. Reference method for broth dilution antifungal susceptibility testing of filamentous fungi, 3rd ed. CLSI standard M38. Wayne: Clinical and Laboratory Standards Institute, 2017.
18.	Sigera LSM, Denning DW. A systematic review of the therapeutic outcome of mucormycosis. Open Forum Infect Dis, 2023, 11(1): ofad704.
19.	Thompson GR 3rd, Garcia-Diaz J, Miceli MH, et al. Systemic antifungal therapy with isavuconazonium sulfate or other agents in adults with invasive mucormycosis or invasive aspergillosis (non-fumigatus): a multicentre, non-interventional registry study. Mycoses, 2022, 65(2): 186-198.
20.	Gunathilaka SS, Keragala RK, Gunathilaka KM, et al. Use of isavuconazole in mucormycosis: a systematic review. BMC Infect Dis, 2025, 25(1): 25.
21.	Jeong W, Keighley C, Wolfe R, et al. Contemporary management and clinical outcomes of mucormycosis: a systematic review and meta-analysis of case reports. Int J Antimicrob Agents, 2019, 53(5): 589-597.
22.	Lu B, Ha D, Shen S, et al. Combination antifungal therapy for invasive mucormycosis in immunocompromised hosts: a single-center experience. Open Forum Infect Dis, 2024, 11(6): ofae103.
23.	Kyvernitakis A, Torres HA, Jiang Y, et al. Initial use of combination treatment does not impact survival of 106 patients with haematologic malignancies and mucormycosis: a propensity score analysis. Clin Microbiol Infect, 2016, 22(9): 811.e1-811.e8.
24.	Bernauer M, Waskin H, Cossrow N, et al. Posaconazole effectiveness in rare invasive fungal infections: a systematic literature review. Int J Antimicrob Agents, 2025, 66(1): 107482.
25.	Marty FM, Ostrosky-Zeichner L, Cornely OA, et al. Isavuconazole treatment for mucormycosis: a single-arm open-label trial and case-control analysis. Lancet Infect Dis, 2016, 16(7): 828-837.
26.	van Burik JA, Hare RS, Solomon HF, et al. Posaconazole is effective as salvage therapy in zygomycosis: a retrospective summary of 91 cases. Clin Infect Dis, 2006, 42(7): e61-e65.
27.	Denis B, Resche-Rigon M, Raffoux E, et al. Epidemiology, clinical manifestations, treatment, and outcome of mucormycosis: a review of 77 cases from a single center in France. Open Forum Infect Dis, 2024, 11(8): ofae426.
28.	Cartau T, Chantepie S, Thuillier-Lecouf A, et al. Epidemiology, clinical, radiological and biological characteristics, and outcomes of mucormycosis: a retrospective study at a French university hospital. J Fungi (Basel), 2024, 10(12): 884.
29.	Skiada A, Pagano L, Groll A, et al. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on zygomycosis between 2005 and 2007. Clin Microbiol Infect, 2011, 17(12): 1859-1867.
30.	Skiada A, Drogari-Apiranthitou M, Roilides E, et al. A global analysis of cases of mucormycosis recorded in the European Confederation of Medical Mycology/International Society for Human and Animal Mycology (ECMM/ISHAM) zygomyco.net registry from 2009 to 2022. Mycopathologia, 2025, 190(4): 53.
31.	Jain AK, Gupta Y, Verma J, et al. Minimizing the recurrence rate in covid associated mucormycosis: our experience in 500 patients. Indian J Otolaryngol Head Neck Surg, 2024, 76(2): 1898-1902.
32.	Sahu M, Shah M, Mallela VR, et al. COVID-19 associated multisystemic mucormycosis from India: a multicentric retrospective study on clinical profile, predisposing factors, cumulative mortality and factors affecting outcome. Infection, 2023, 51(2): 407-416.
33.	?zbek L, Top?u U, Manay M, et al. COVID-19-associated mucormycosis: a systematic review and meta-analysis of 958 cases. Clin Microbiol Infect, 2023, 29(6): 722-731.
34.	Corzo-León DE, Chora-Hernández LD, Rodríguez-Zulueta AP, et al. Diabetes mellitus as the major risk factor for mucormycosis in Mexico: epidemiology, diagnosis, and outcomes of reported cases. Med Mycol, 2018, 56(1): 29-43.
35.	Rizvi SWA, Khan S, Shahbaz M, et al. Long-term outcomes of transcutaneous retrobulbar amphotericin B in COVID-19-associated mucormycosis. Indian J Ophthalmol, 2023, 71(2): 452-456.
36.	Shakrawal J, Sharma V, Goyal A, et al. Outcomes of transcutaneous retrobulbar amphotericin B (TRAMB) as an adjuvant therapy for rhino-orbital-cerebral mucormycosis (ROCM) following COVID-19. Int Ophthalmol, 2023, 43(6): 1919-1926.
37.	Sharifi A, Akbari Z, Shafie’ei M, et al. Retrobulbar injection of amphotericin b in patients with COVID-19 associated orbital mucormycosis: a systematic review. Ophthalmic Plast Reconstr Surg, 2022, 38(5): 425-432.
38.	Honavar SG. Code Mucor: guidelines for the diagnosis, staging and management of rhino-orbito-cerebral mucormycosis in the setting of COVID-19. Indian J Ophthalmol, 2021, 69(6): 1361-1365.
39.	K?mür S, ?nal AS, Kurtaran B, et al. Mucormycosis: a 10-year experience at a tertiary care center in Turkey. Turk J Med Sci, 2016, 46(1): 58-62.
40.	Manesh A, Rupali P, Sullivan MO, et al. Mucormycosis-a clinicoepidemiological review of cases over 10 years. Mycoses, 2019, 62(4): 391-398.
41.	Manade VV, Kotecha MR. A clinical study of rhino-orbital-cerebral mucormycosis during the COVID-19 pandemic in western Maharashtra. J Family Med Prim Care, 2024, 13(9): 3730-3734.
42.	Patel A, Kaur H, Xess I, et al. A multicentre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India. Clin Microbiol Infect, 2020, 26(7): 944.e9-944.e15.
43.	Chopra S, Setiya S, Waknis PP, et al. Various treatment modalities in COVID-19 associated facial mucormycosis and the need for its surgical management: a systematic review. J Maxillofac Oral Surg, 2023, 13: 1-22.
44.	Vironneau P, Kania R, Morizot G, et al. Local control of rhino-orbito-cerebral mucormycosis dramatically impacts survival. Clin Microbiol Infect, 2014, 20(5): O336-O339.
45.	Sen M, Honavar SG, Bansal R, et al. Epidemiology, clinical profile, management, and outcome of COVID-19-associated rhino-orbital-cerebral mucormycosis in 2826 patients in India- Collaborative OPAI-IJO Study on Mucormycosis in COVID-19 (COSMIC), report 1. Indian J Ophthalmol, 2021, 69(7): 1670-1692.
46.	Wu S, Wei Z, He Z, et al. Clinical characteristics of tracheobronchial mucormycosis: a retrospective analysis of twenty cases. Ann Med, 2025, 57(1): 2584286.
47.	Fan Z, Yang C, Zhang L, et al. Safety and efficacy of bronchoscopic interventions for tracheobronchial mucormycosis: a 27-patient retrospective cohort study. BMC Pulm Med, 2025, 25(1): 505.
48.	Muthu V, Agarwal R, Dhooria S, et al. Has the mortality from pulmonary mucormycosis changed over time? A systematic review and meta-analysis. Clin Microbiol Infect, 2021, 27(4): 538-549.
49.	Li H, Hwang SK, Zhou C, et al. Gangrenous cutaneous mucormycosis caused by Rhizopus oryzae: a case report and review of primary cutaneous mucormycosis in China over past 20 years. Mycopathologia, 2013, 176(1/2): 123-128.
50.	Didehdar M, Chegini Z, Khoshbayan A, et al. Clinical presentations, diagnosis, management, and outcomes of renal mucormycosis: an overview of case reports. Front Med (Lausanne), 2022, 9: 983612.
51.	Kumar RK, Annigeri RA, Gopalakrishnan R, et al. Bilateral renal mucormycosis following COVID-19 infection: a therapeutic challenge. Clin Nephrol Case Stud, 2022, 10: 76-81.
52.	Bhadauria D, Etta P, Chelappan A, et al. Isolated bilateral renal mucormycosis in apparently immunocompetent patients-a case series from India and review of the literature. Clin Kidney J, 2018, 11(6): 769-776.
53.	Kaur H, Ghosh A, Rudramurthy SM, et al. Gastrointestinal mucormycosis in apparently immunocompetent hosts-a review. Mycoses, 2018, 61(12): 898-908.
54.	Henry B, Lefevre Utile A, Jaureguiberry S, et al. Gastrointestinal and intra-abdominal mucormycosis in non-haematological patients-a comprehensive review. J Fungi (Basel), 2025, 11(4): 298.
55.	Didehdar M, Chegini Z, Moradabadi A, et al. Gastrointestinal mucormycosis: a periodic systematic review of case reports from 2015 to 2021. Microb Pathog, 2022, 163: 105388.
56.	Karigane D, Kikuchi T, Sakurai M, et al. Invasive hepatic mucormycosis: a case report and review of the literature. J Infect Chemother, 2019, 25(1): 50-53.
57.	Allos H, Hicklen RS, Matsuo T, et al. The heterogenous presentation of hepatic mucormycosis in adults: a case report and review of the literature. J Fungi (Basel), 2025, 11(6): 408.
58.	Valdez-Martinez A, Santoyo-Alejandre MI, Arenas R, et al. Neonatal mucormycosis: a rare but highly lethal fungal infection in term and preterm newborns-a 20-year systematic review. Trop Med Infect Dis, 2025, 10(4): 86.
59.	Elitzur S, Fischer S, Arad-Cohen N, et al. Disseminated mucormycosis in immunocompromised children: are new antifungal agents making a difference? A multicenter retrospective study. J Fungi (Basel), 2021, 7(3): 165.
60.	Motamedi M, Golmohammadi Z, Yazdanpanah S, et al. Epidemiology, clinical features, therapeutic interventions and outcomes of mucormycosis in Shiraz: an 8-year retrospective case study with comparison between children and adults. Sci Rep, 2022, 12(1): 17174.
61.	Muggeo P, Calore E, Decembrino N, et al. Invasive mucormycosis in children with cancer: a retrospective study from the Infection Working Group of Italian Pediatric Hematology Oncology Association. Mycoses, 2019, 62(2): 165-170.
62.	Pana ZD, Seidel D, Skiada A, et al. Invasive mucormycosis in children: an epidemiologic study in European and non-European countries based on two registries. BMC Infect Dis, 2016, 16(1): 667.
63.	Zhu C, Gu Y, Zhu Q, et al. Management of invasive bronchopulmonary mucormycosis with low-dose antifungal therapy and left lower lobectomy in a patient with renal insufficiency. Infect Drug Resist, 2025, 18: 3629-3635.
64.	Armstrong-James D, Koh M, Ostermann M, et al. Optimal management of acute kidney injury in critically ill patients with invasive fungal infections being treated with liposomal amphotericin B. BMJ Case Rep, 2020, 13(5): e233072.
65.	Kofteridis DP, Karabekios S, Panagiotides JG, et al. Successful treatment of rhinocerebral mucormycosis with liposomal amphotericin B and surgery in two diabetic patients with renal dysfunction. J Chemother, 2003, 15(3): 282-286.
66.	Kumar M, Tanwar P, Radhika S, et al. Fine needle aspiration cytology of primary mucormycosis of the breast in a young immunocompetent pregnant woman. Cytopathology, 2013, 24(6): 411-412.
67.	Trivedi TH, Jadhav DL, Yeolekar ME, et al. Rhinocerebral mucormycosis in a pregnant woman with diabetic ketoacidosis. J Assoc Physicians India, 2002, 50: 592-594.
68.	Buhl MR, Joseph TP, Snelling BE, et al. Temporofacial zygomycosis in a pregnant woman. Infection, 1992, 20(4): 230-232.
69.	Shahin MA, Abu-Elenin MM, Nada HE. Effect of nurse-led intervention on knowledge and preventive behavior of diabetic pregnant women regarding COVID-19 associated mucromycosis infection in mid-delta region of Egypt. BMC Nurs, 2023, 22(1): 175.
70.	Palomba E, Colaneri M, Azzarà C, et al. Epidemiology, clinical manifestations, and outcome of mucormycosis in solid organ transplant recipients: a systematic review of reported cases. Open Forum Infect Dis, 2024, 11(6): ofae043.
71.	Song Y, Qiao J, Giovanni G, et al. Mucormycosis in renal transplant recipients: review of 174 reported cases. BMC Infect Dis, 2017, 17(1): 283.
72.	Wand O, Unterman A, Izhakian S, et al. Mucormycosis in lung transplant recipients: a systematic review of the literature and a case series. Clin Transplant, 2020, 34(2): e13774.
73.	Aceves-Sánchez B, Rojas-Casta?eda E, Ponce-de-León A, et al. Mucormycosis after liver transplant: case series and literature review. Med Mycol Case Rep, 2024, 46: 100686.
74.	李川, 馬瑞, 王啟, 等. 異基因造血干細胞移植后侵襲性毛霉病患者的臨床特征及預后影響因素分析. 中華醫學雜志, 2025, 105(32): 2731-2737.
75.	Kwon M, Gómez-Centurión I, Oarbeascoa G, et al. Real-world experience with isavuconazole in allogeneic stem cell transplantation in Spain. Transplant Cell Ther, 2024, 30(10): 1033. e1-1033. e8.
76.	Wang ZJ, Zhang J, Shi YY. Successful oral isavuconazole monotherapy for invasive pulmonary mucormycosis in kidney transplant recipients: case reports and literature review. Transplant Proc, 2025, 57(4): 544-551.
77.	Dvo?á?ková E, Zajacová A, Havlín J, et al. Demonstration of the rationale for therapeutic drug monitoring of isavuconazole: a case report with a lung transplant recipient. Prague Med Rep, 2023, 124(4): 444-448.
78.	Dolton MJ, Perera V, Pont LG, et al. Terbinafine in combination with other antifungal agents for treatment of resistant or refractory mycoses: investigating optimal dosing regimens using a physiologically based pharmacokinetic model. Antimicrob Agents Chemother, 2014, 58(1): 48-54.
79.	Arbabi A, Haghani I, Naghshvar F, et al. Formulation, characterization, and in vitro antifungal evaluation of liposomal terbinafine prepared by the ethanol injection method. Curr Med Mycol, 2025, 11: 1686.
80.	Revankar SG, Nailor MD, Sobel JD. Use of terbinafine in rare and refractory mycoses. Future Microbiol, 2008, 3(1): 9-17.
81.	Vitale RG, de Hoog GS, Schwarz P, et al. Antifungal susceptibility and phylogeny of opportunistic members of the order Mucorales. J Clin Microbiol, 2012, 50(1): 66-75.
82.	Almyroudis NG, Sutton DA, Fothergill AW, et al. In vitro susceptibilities of 217 clinical isolates of zygomycetes to conventional and new antifungal agents. Antimicrob Agents Chemother, 2007, 51(7): 2587-2590.
83.	Alastruey-Izquierdo A, Cuesta I, Walther G, et al. Antifungal susceptibility profile of human-pathogenic species of lichtheimia. Antimicrob Agents Chemother, 2010, 54(7): 3058-3060.
84.	Abuali MM, Posada R, Del Toro G, et al. Rhizomucor variabilis var. regularior and Hormographiella aspergillata infections in a leukemic bone marrow transplant recipient with refractory neutropenia. J Clin Microbiol, 2009, 47(12): 4176-4179.
85.	Hemashettar BM, Patil RN, O’Donnell K, et al. Chronic rhinofacial mucormycosis caused by mucor irregularis (Rhizomucor variabilis) in India. J Clin Microbiol, 2011, 49(6): 2372-2375.
86.	Spellberg B, Fu Y, Edwards JE Jr, et al. Combination therapy with amphotericin B lipid complex and caspofungin acetate of disseminated zygomycosis in diabetic ketoacidotic mice. Antimicrob Agents Chemother, 2005, 49(2): 830-832.
87.	Ibrahim AS, Gebremariam T, Fu Y, et al. Combination echinocandin-polyene treatment of murine mucormycosis. Antimicrob Agents Chemother, 2008, 52(4): 1556-1558.
88.	Klimko NN, Khostelidi SN, Volkova AG, et al. Mucormycosis in haematological patients: case report and results of prospective study in Saint Petersburg, Russia. Mycoses, 2014, 57(Suppl 3): 91-96.
89.	Reed C, Bryant R, Ibrahim AS, et al. Combination polyene-caspofungin treatment of rhino-orbital-cerebral mucormycosis. Clin Infect Dis, 2008, 47(3): 364-371.
90.	Abidi MZ, Sohail MR, Cummins N, et al. Stability in the cumulative incidence, severity and mortality of 101 cases of invasive mucormycosis in high-risk patients from 1995 to 2011: a comparison of eras immediately before and after the availability of voriconazole and echinocandin-amphotericin combination therapies. Mycoses, 2014, 57(11): 687-698.
91.	Egger M, Bellmann R, Krause R, et al. Salvage treatment for invasive aspergillosis and mucormycosis: challenges, recommendations and future considerations. Infect Drug Resist, 2023, 16: 2167-2178.
92.	Shaw KJ, Ibrahim AS. Fosmanogepix: a review of the first-in-class broad spectrum agent for the treatment of invasive fungal infections. J Fungi (Basel), 2020, 6(4): 239.
93.	Gebremariam T, Alkhazraji S, Gu Y, et al. Ibrexafungerp is efficacious in a neutropenic murine model of pulmonary mucormycosis as monotherapy and combined with liposomal amphotericin B. Antimicrob Agents Chemother, 2024, 68(5): e0154523.
94.	Hoenigl M, Sprute R, Egger M, et al. The antifungal pipeline: fosmanogepix, ibrexafungerp, olorofim, opelconazole, and rezafungin. Drugs, 2021, 81(15): 1703-1729.
95.	Reed C, Ibrahim A, Edwards JE Jr, et al. Deferasirox, an iron-chelating agent, as salvage therapy for rhinocerebral mucormycosis. Antimicrob Agents Chemother, 2006, 50(11): 3968-3969.
96.	Gao Y, Wang H, Bai XF, et al. Successful management of refractory pulmonary mucormycosis using intracavitary amphotericin B: a case report and literature review. Am J Case Rep, 2025, 26: e949413.
97.	Alqarihi A, Kontoyiannis DP, Ibrahim AS. Mucormycosis in 2023: an update on pathogenesis and management. Front Cell Infect Microbiol, 2023, 13: 1254919.
98.	Williamson PR. Post-infectious inflammatory response syndrome (PIIRS): dissociation of T-cell-macrophage signaling in previously healthy individuals with cryptococcal fungal meningoencephalitis. Macrophage (Houst), 2015, 2: e1078.
99.	Ito Y, Hoeltermann TA, Anjum S, et al. Corticosteroid therapy and long-term outcomes of post-infectious inflammatory syndrome in non-HIV immunosuppressed cryptococcal meningitis: a multicenter case series. J Infect Dis, 2026, 233(2): e553-e560.
100.	Danion F, Coste A, Le Hyaric C, et al. What is new in pulmonary mucormycosis?. J Fungi (Basel), 2023, 9(3): 307.
101.	Amanati A, Jahromi MG, Jafarian H, et al. Aspergillus-related immune reconstitution inflammatory syndrome in pediatric cancer patients, clinical characteristics, imaging findings, and survival. BMC Infect Dis, 2024, 24(1): 1423.
102.	Lionakis MS, Drummond RA, Hohl TM. Immune responses to human fungal pathogens and therapeutic prospects. Nat Rev Immunol, 2023, 23(7): 433-452.
103.	Hargarten JC, Anjum SH, Ssebambulidde K, et al. Tocilizumab as a potential adjunctive therapy to corticosteroids in cryptococcal post-infectious inflammatory response syndrome (PIIRS): a report of two cases. J Clin Immunol, 2023, 43(8): 2146-2155.
104.	Banz M, Schleenvoigt B, Eckardt N, et al. Successful management of severe IRIS associated with disseminated histoplasmosis in an HIV patient using cytokine adsorption therapy and JAK inhibition. AIDS Res Ther, 2025, 22(1): 123.

1. Patel A, Agarwal R, Rudramurthy SM, et al. Multicenter epidemiologic study of coronavirus disease-associated mucormycosis, India. Emerg Infect Dis, 2021, 27(9): 2349-2359.
2. Muthukumarasamy N, Suzuki H. Longitudinal epidemiology of mucormycosis within the veterans health administration: a retrospective cohort study over a 20-year period. Mycoses, 2024, 67(9): e13794.
3. Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis, 2005, 41(5): 634-653.
4. Gouzien L, Che D, Cassaing S, et al. Epidemiology and prognostic factors of mucormycosis in France (2012-2022): a cross-sectional study nested in a prospective surveillance programme. Lancet Reg Health Eur, 2024, 45: 101010.
5. Chamilos G, Lewis RE, Kontoyiannis DP. Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin Infect Dis, 2008, 47(4): 503-509.
6. Chakrabarti A, Das A, Mandal J, et al. The rising trend of invasive zygomycosis in patients with uncontrolled diabetes mellitus. Med Mycol, 2006, 44(4): 335-342.
7. Skiada A, Pavleas I, Drogari-Apiranthitou M. Epidemiological trends of mucormycosis in europe, comparison with other continents. Mycopathologia, 2024, 189(6): 100.
8. Alastruey-Izquierdo A, Castelli MV, Cuesta I, et al. In vitro activity of antifungals against zygomycetes. Clin Microbiol Infect, 2009, 15(Suppl 5): 71-76.
9. Pastor FJ, Ruíz-Cendoya M, Pujol I, et al. In vitro and in vivo antifungal susceptibilities of the mucoralean fungus Cunninghamella. Antimicrob Agents Chemother, 2010, 54(11): 4550-4555.
10. Salas V, Pastor FJ, Calvo E, et al. In vitro and in vivo activities of posaconazole and amphotericin B in a murine invasive infection by mucor circinelloides: poor efficacy of posaconazole. Antimicrob Agents Chemother, 2012, 56(5): 2246-2250.
11. Cornely OA, Alastruey-Izquierdo A, Arenz D, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis, 2019, 19(12): e405-e421.
12. Neblett Fanfair R, Benedict K, Bos J, et al. Necrotizing cutaneous mucormycosis after a tornado in Joplin, Missouri, in 2011. N Engl J Med, 2012, 367(23): 2214-2225.
13. Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev, 2005, 18(3): 556-569.
14. Badali H, Ca?ete-Gibas C, McCarthy D, et al. Epidemiology and antifungal susceptibilities of mucoralean fungi in clinical samples from the United States. J Clin Microbiol, 2021, 59(9): e0123021.
15. Borman AM, Fraser M, Patterson Z, et al. In vitro antifungal drug resistance profiles of clinically relevant members of the Mucorales (mucoromycota) especially with the newer triazoles. J Fungi (Basel), 2021, 7(4): 271.
16. Escribano P, Mesquida A, López-Montesinos S, et al. Amphotericin B, itraconazole, posaconazole, and isavuconazole MICs against clinical Mucorales isolates obtained by visual inspection and spectrophotometric reading according to the EUCAST 9. 4 procedure. Med Mycol, 2023, 61(5): myad045.
17. Clinical and Laboratory Standards Institute. Reference method for broth dilution antifungal susceptibility testing of filamentous fungi, 3rd ed. CLSI standard M38. Wayne: Clinical and Laboratory Standards Institute, 2017.
18. Sigera LSM, Denning DW. A systematic review of the therapeutic outcome of mucormycosis. Open Forum Infect Dis, 2023, 11(1): ofad704.
19. Thompson GR 3rd, Garcia-Diaz J, Miceli MH, et al. Systemic antifungal therapy with isavuconazonium sulfate or other agents in adults with invasive mucormycosis or invasive aspergillosis (non-fumigatus): a multicentre, non-interventional registry study. Mycoses, 2022, 65(2): 186-198.
20. Gunathilaka SS, Keragala RK, Gunathilaka KM, et al. Use of isavuconazole in mucormycosis: a systematic review. BMC Infect Dis, 2025, 25(1): 25.
21. Jeong W, Keighley C, Wolfe R, et al. Contemporary management and clinical outcomes of mucormycosis: a systematic review and meta-analysis of case reports. Int J Antimicrob Agents, 2019, 53(5): 589-597.
22. Lu B, Ha D, Shen S, et al. Combination antifungal therapy for invasive mucormycosis in immunocompromised hosts: a single-center experience. Open Forum Infect Dis, 2024, 11(6): ofae103.
23. Kyvernitakis A, Torres HA, Jiang Y, et al. Initial use of combination treatment does not impact survival of 106 patients with haematologic malignancies and mucormycosis: a propensity score analysis. Clin Microbiol Infect, 2016, 22(9): 811.e1-811.e8.
24. Bernauer M, Waskin H, Cossrow N, et al. Posaconazole effectiveness in rare invasive fungal infections: a systematic literature review. Int J Antimicrob Agents, 2025, 66(1): 107482.
25. Marty FM, Ostrosky-Zeichner L, Cornely OA, et al. Isavuconazole treatment for mucormycosis: a single-arm open-label trial and case-control analysis. Lancet Infect Dis, 2016, 16(7): 828-837.
26. van Burik JA, Hare RS, Solomon HF, et al. Posaconazole is effective as salvage therapy in zygomycosis: a retrospective summary of 91 cases. Clin Infect Dis, 2006, 42(7): e61-e65.
27. Denis B, Resche-Rigon M, Raffoux E, et al. Epidemiology, clinical manifestations, treatment, and outcome of mucormycosis: a review of 77 cases from a single center in France. Open Forum Infect Dis, 2024, 11(8): ofae426.
28. Cartau T, Chantepie S, Thuillier-Lecouf A, et al. Epidemiology, clinical, radiological and biological characteristics, and outcomes of mucormycosis: a retrospective study at a French university hospital. J Fungi (Basel), 2024, 10(12): 884.
29. Skiada A, Pagano L, Groll A, et al. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on zygomycosis between 2005 and 2007. Clin Microbiol Infect, 2011, 17(12): 1859-1867.
30. Skiada A, Drogari-Apiranthitou M, Roilides E, et al. A global analysis of cases of mucormycosis recorded in the European Confederation of Medical Mycology/International Society for Human and Animal Mycology (ECMM/ISHAM) zygomyco.net registry from 2009 to 2022. Mycopathologia, 2025, 190(4): 53.
31. Jain AK, Gupta Y, Verma J, et al. Minimizing the recurrence rate in covid associated mucormycosis: our experience in 500 patients. Indian J Otolaryngol Head Neck Surg, 2024, 76(2): 1898-1902.
32. Sahu M, Shah M, Mallela VR, et al. COVID-19 associated multisystemic mucormycosis from India: a multicentric retrospective study on clinical profile, predisposing factors, cumulative mortality and factors affecting outcome. Infection, 2023, 51(2): 407-416.
33. ?zbek L, Top?u U, Manay M, et al. COVID-19-associated mucormycosis: a systematic review and meta-analysis of 958 cases. Clin Microbiol Infect, 2023, 29(6): 722-731.
34. Corzo-León DE, Chora-Hernández LD, Rodríguez-Zulueta AP, et al. Diabetes mellitus as the major risk factor for mucormycosis in Mexico: epidemiology, diagnosis, and outcomes of reported cases. Med Mycol, 2018, 56(1): 29-43.
35. Rizvi SWA, Khan S, Shahbaz M, et al. Long-term outcomes of transcutaneous retrobulbar amphotericin B in COVID-19-associated mucormycosis. Indian J Ophthalmol, 2023, 71(2): 452-456.
36. Shakrawal J, Sharma V, Goyal A, et al. Outcomes of transcutaneous retrobulbar amphotericin B (TRAMB) as an adjuvant therapy for rhino-orbital-cerebral mucormycosis (ROCM) following COVID-19. Int Ophthalmol, 2023, 43(6): 1919-1926.
37. Sharifi A, Akbari Z, Shafie’ei M, et al. Retrobulbar injection of amphotericin b in patients with COVID-19 associated orbital mucormycosis: a systematic review. Ophthalmic Plast Reconstr Surg, 2022, 38(5): 425-432.
38. Honavar SG. Code Mucor: guidelines for the diagnosis, staging and management of rhino-orbito-cerebral mucormycosis in the setting of COVID-19. Indian J Ophthalmol, 2021, 69(6): 1361-1365.
39. K?mür S, ?nal AS, Kurtaran B, et al. Mucormycosis: a 10-year experience at a tertiary care center in Turkey. Turk J Med Sci, 2016, 46(1): 58-62.
40. Manesh A, Rupali P, Sullivan MO, et al. Mucormycosis-a clinicoepidemiological review of cases over 10 years. Mycoses, 2019, 62(4): 391-398.
41. Manade VV, Kotecha MR. A clinical study of rhino-orbital-cerebral mucormycosis during the COVID-19 pandemic in western Maharashtra. J Family Med Prim Care, 2024, 13(9): 3730-3734.
42. Patel A, Kaur H, Xess I, et al. A multicentre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India. Clin Microbiol Infect, 2020, 26(7): 944.e9-944.e15.
43. Chopra S, Setiya S, Waknis PP, et al. Various treatment modalities in COVID-19 associated facial mucormycosis and the need for its surgical management: a systematic review. J Maxillofac Oral Surg, 2023, 13: 1-22.
44. Vironneau P, Kania R, Morizot G, et al. Local control of rhino-orbito-cerebral mucormycosis dramatically impacts survival. Clin Microbiol Infect, 2014, 20(5): O336-O339.
45. Sen M, Honavar SG, Bansal R, et al. Epidemiology, clinical profile, management, and outcome of COVID-19-associated rhino-orbital-cerebral mucormycosis in 2826 patients in India- Collaborative OPAI-IJO Study on Mucormycosis in COVID-19 (COSMIC), report 1. Indian J Ophthalmol, 2021, 69(7): 1670-1692.
46. Wu S, Wei Z, He Z, et al. Clinical characteristics of tracheobronchial mucormycosis: a retrospective analysis of twenty cases. Ann Med, 2025, 57(1): 2584286.
47. Fan Z, Yang C, Zhang L, et al. Safety and efficacy of bronchoscopic interventions for tracheobronchial mucormycosis: a 27-patient retrospective cohort study. BMC Pulm Med, 2025, 25(1): 505.
48. Muthu V, Agarwal R, Dhooria S, et al. Has the mortality from pulmonary mucormycosis changed over time? A systematic review and meta-analysis. Clin Microbiol Infect, 2021, 27(4): 538-549.
49. Li H, Hwang SK, Zhou C, et al. Gangrenous cutaneous mucormycosis caused by Rhizopus oryzae: a case report and review of primary cutaneous mucormycosis in China over past 20 years. Mycopathologia, 2013, 176(1/2): 123-128.
50. Didehdar M, Chegini Z, Khoshbayan A, et al. Clinical presentations, diagnosis, management, and outcomes of renal mucormycosis: an overview of case reports. Front Med (Lausanne), 2022, 9: 983612.
51. Kumar RK, Annigeri RA, Gopalakrishnan R, et al. Bilateral renal mucormycosis following COVID-19 infection: a therapeutic challenge. Clin Nephrol Case Stud, 2022, 10: 76-81.
52. Bhadauria D, Etta P, Chelappan A, et al. Isolated bilateral renal mucormycosis in apparently immunocompetent patients-a case series from India and review of the literature. Clin Kidney J, 2018, 11(6): 769-776.
53. Kaur H, Ghosh A, Rudramurthy SM, et al. Gastrointestinal mucormycosis in apparently immunocompetent hosts-a review. Mycoses, 2018, 61(12): 898-908.
54. Henry B, Lefevre Utile A, Jaureguiberry S, et al. Gastrointestinal and intra-abdominal mucormycosis in non-haematological patients-a comprehensive review. J Fungi (Basel), 2025, 11(4): 298.
55. Didehdar M, Chegini Z, Moradabadi A, et al. Gastrointestinal mucormycosis: a periodic systematic review of case reports from 2015 to 2021. Microb Pathog, 2022, 163: 105388.
56. Karigane D, Kikuchi T, Sakurai M, et al. Invasive hepatic mucormycosis: a case report and review of the literature. J Infect Chemother, 2019, 25(1): 50-53.
57. Allos H, Hicklen RS, Matsuo T, et al. The heterogenous presentation of hepatic mucormycosis in adults: a case report and review of the literature. J Fungi (Basel), 2025, 11(6): 408.
58. Valdez-Martinez A, Santoyo-Alejandre MI, Arenas R, et al. Neonatal mucormycosis: a rare but highly lethal fungal infection in term and preterm newborns-a 20-year systematic review. Trop Med Infect Dis, 2025, 10(4): 86.
59. Elitzur S, Fischer S, Arad-Cohen N, et al. Disseminated mucormycosis in immunocompromised children: are new antifungal agents making a difference? A multicenter retrospective study. J Fungi (Basel), 2021, 7(3): 165.
60. Motamedi M, Golmohammadi Z, Yazdanpanah S, et al. Epidemiology, clinical features, therapeutic interventions and outcomes of mucormycosis in Shiraz: an 8-year retrospective case study with comparison between children and adults. Sci Rep, 2022, 12(1): 17174.
61. Muggeo P, Calore E, Decembrino N, et al. Invasive mucormycosis in children with cancer: a retrospective study from the Infection Working Group of Italian Pediatric Hematology Oncology Association. Mycoses, 2019, 62(2): 165-170.
62. Pana ZD, Seidel D, Skiada A, et al. Invasive mucormycosis in children: an epidemiologic study in European and non-European countries based on two registries. BMC Infect Dis, 2016, 16(1): 667.
63. Zhu C, Gu Y, Zhu Q, et al. Management of invasive bronchopulmonary mucormycosis with low-dose antifungal therapy and left lower lobectomy in a patient with renal insufficiency. Infect Drug Resist, 2025, 18: 3629-3635.
64. Armstrong-James D, Koh M, Ostermann M, et al. Optimal management of acute kidney injury in critically ill patients with invasive fungal infections being treated with liposomal amphotericin B. BMJ Case Rep, 2020, 13(5): e233072.
65. Kofteridis DP, Karabekios S, Panagiotides JG, et al. Successful treatment of rhinocerebral mucormycosis with liposomal amphotericin B and surgery in two diabetic patients with renal dysfunction. J Chemother, 2003, 15(3): 282-286.
66. Kumar M, Tanwar P, Radhika S, et al. Fine needle aspiration cytology of primary mucormycosis of the breast in a young immunocompetent pregnant woman. Cytopathology, 2013, 24(6): 411-412.
67. Trivedi TH, Jadhav DL, Yeolekar ME, et al. Rhinocerebral mucormycosis in a pregnant woman with diabetic ketoacidosis. J Assoc Physicians India, 2002, 50: 592-594.
68. Buhl MR, Joseph TP, Snelling BE, et al. Temporofacial zygomycosis in a pregnant woman. Infection, 1992, 20(4): 230-232.
69. Shahin MA, Abu-Elenin MM, Nada HE. Effect of nurse-led intervention on knowledge and preventive behavior of diabetic pregnant women regarding COVID-19 associated mucromycosis infection in mid-delta region of Egypt. BMC Nurs, 2023, 22(1): 175.
70. Palomba E, Colaneri M, Azzarà C, et al. Epidemiology, clinical manifestations, and outcome of mucormycosis in solid organ transplant recipients: a systematic review of reported cases. Open Forum Infect Dis, 2024, 11(6): ofae043.
71. Song Y, Qiao J, Giovanni G, et al. Mucormycosis in renal transplant recipients: review of 174 reported cases. BMC Infect Dis, 2017, 17(1): 283.
72. Wand O, Unterman A, Izhakian S, et al. Mucormycosis in lung transplant recipients: a systematic review of the literature and a case series. Clin Transplant, 2020, 34(2): e13774.
73. Aceves-Sánchez B, Rojas-Casta?eda E, Ponce-de-León A, et al. Mucormycosis after liver transplant: case series and literature review. Med Mycol Case Rep, 2024, 46: 100686.
74. 李川, 馬瑞, 王啟, 等. 異基因造血干細胞移植后侵襲性毛霉病患者的臨床特征及預后影響因素分析. 中華醫學雜志, 2025, 105(32): 2731-2737.
75. Kwon M, Gómez-Centurión I, Oarbeascoa G, et al. Real-world experience with isavuconazole in allogeneic stem cell transplantation in Spain. Transplant Cell Ther, 2024, 30(10): 1033. e1-1033. e8.
76. Wang ZJ, Zhang J, Shi YY. Successful oral isavuconazole monotherapy for invasive pulmonary mucormycosis in kidney transplant recipients: case reports and literature review. Transplant Proc, 2025, 57(4): 544-551.
77. Dvo?á?ková E, Zajacová A, Havlín J, et al. Demonstration of the rationale for therapeutic drug monitoring of isavuconazole: a case report with a lung transplant recipient. Prague Med Rep, 2023, 124(4): 444-448.
78. Dolton MJ, Perera V, Pont LG, et al. Terbinafine in combination with other antifungal agents for treatment of resistant or refractory mycoses: investigating optimal dosing regimens using a physiologically based pharmacokinetic model. Antimicrob Agents Chemother, 2014, 58(1): 48-54.
79. Arbabi A, Haghani I, Naghshvar F, et al. Formulation, characterization, and in vitro antifungal evaluation of liposomal terbinafine prepared by the ethanol injection method. Curr Med Mycol, 2025, 11: 1686.
80. Revankar SG, Nailor MD, Sobel JD. Use of terbinafine in rare and refractory mycoses. Future Microbiol, 2008, 3(1): 9-17.
81. Vitale RG, de Hoog GS, Schwarz P, et al. Antifungal susceptibility and phylogeny of opportunistic members of the order Mucorales. J Clin Microbiol, 2012, 50(1): 66-75.
82. Almyroudis NG, Sutton DA, Fothergill AW, et al. In vitro susceptibilities of 217 clinical isolates of zygomycetes to conventional and new antifungal agents. Antimicrob Agents Chemother, 2007, 51(7): 2587-2590.
83. Alastruey-Izquierdo A, Cuesta I, Walther G, et al. Antifungal susceptibility profile of human-pathogenic species of lichtheimia. Antimicrob Agents Chemother, 2010, 54(7): 3058-3060.
84. Abuali MM, Posada R, Del Toro G, et al. Rhizomucor variabilis var. regularior and Hormographiella aspergillata infections in a leukemic bone marrow transplant recipient with refractory neutropenia. J Clin Microbiol, 2009, 47(12): 4176-4179.
85. Hemashettar BM, Patil RN, O’Donnell K, et al. Chronic rhinofacial mucormycosis caused by mucor irregularis (Rhizomucor variabilis) in India. J Clin Microbiol, 2011, 49(6): 2372-2375.
86. Spellberg B, Fu Y, Edwards JE Jr, et al. Combination therapy with amphotericin B lipid complex and caspofungin acetate of disseminated zygomycosis in diabetic ketoacidotic mice. Antimicrob Agents Chemother, 2005, 49(2): 830-832.
87. Ibrahim AS, Gebremariam T, Fu Y, et al. Combination echinocandin-polyene treatment of murine mucormycosis. Antimicrob Agents Chemother, 2008, 52(4): 1556-1558.
88. Klimko NN, Khostelidi SN, Volkova AG, et al. Mucormycosis in haematological patients: case report and results of prospective study in Saint Petersburg, Russia. Mycoses, 2014, 57(Suppl 3): 91-96.
89. Reed C, Bryant R, Ibrahim AS, et al. Combination polyene-caspofungin treatment of rhino-orbital-cerebral mucormycosis. Clin Infect Dis, 2008, 47(3): 364-371.
90. Abidi MZ, Sohail MR, Cummins N, et al. Stability in the cumulative incidence, severity and mortality of 101 cases of invasive mucormycosis in high-risk patients from 1995 to 2011: a comparison of eras immediately before and after the availability of voriconazole and echinocandin-amphotericin combination therapies. Mycoses, 2014, 57(11): 687-698.
91. Egger M, Bellmann R, Krause R, et al. Salvage treatment for invasive aspergillosis and mucormycosis: challenges, recommendations and future considerations. Infect Drug Resist, 2023, 16: 2167-2178.
92. Shaw KJ, Ibrahim AS. Fosmanogepix: a review of the first-in-class broad spectrum agent for the treatment of invasive fungal infections. J Fungi (Basel), 2020, 6(4): 239.
93. Gebremariam T, Alkhazraji S, Gu Y, et al. Ibrexafungerp is efficacious in a neutropenic murine model of pulmonary mucormycosis as monotherapy and combined with liposomal amphotericin B. Antimicrob Agents Chemother, 2024, 68(5): e0154523.
94. Hoenigl M, Sprute R, Egger M, et al. The antifungal pipeline: fosmanogepix, ibrexafungerp, olorofim, opelconazole, and rezafungin. Drugs, 2021, 81(15): 1703-1729.
95. Reed C, Ibrahim A, Edwards JE Jr, et al. Deferasirox, an iron-chelating agent, as salvage therapy for rhinocerebral mucormycosis. Antimicrob Agents Chemother, 2006, 50(11): 3968-3969.
96. Gao Y, Wang H, Bai XF, et al. Successful management of refractory pulmonary mucormycosis using intracavitary amphotericin B: a case report and literature review. Am J Case Rep, 2025, 26: e949413.
97. Alqarihi A, Kontoyiannis DP, Ibrahim AS. Mucormycosis in 2023: an update on pathogenesis and management. Front Cell Infect Microbiol, 2023, 13: 1254919.
98. Williamson PR. Post-infectious inflammatory response syndrome (PIIRS): dissociation of T-cell-macrophage signaling in previously healthy individuals with cryptococcal fungal meningoencephalitis. Macrophage (Houst), 2015, 2: e1078.
99. Ito Y, Hoeltermann TA, Anjum S, et al. Corticosteroid therapy and long-term outcomes of post-infectious inflammatory syndrome in non-HIV immunosuppressed cryptococcal meningitis: a multicenter case series. J Infect Dis, 2026, 233(2): e553-e560.
100. Danion F, Coste A, Le Hyaric C, et al. What is new in pulmonary mucormycosis?. J Fungi (Basel), 2023, 9(3): 307.
101. Amanati A, Jahromi MG, Jafarian H, et al. Aspergillus-related immune reconstitution inflammatory syndrome in pediatric cancer patients, clinical characteristics, imaging findings, and survival. BMC Infect Dis, 2024, 24(1): 1423.
102. Lionakis MS, Drummond RA, Hohl TM. Immune responses to human fungal pathogens and therapeutic prospects. Nat Rev Immunol, 2023, 23(7): 433-452.
103. Hargarten JC, Anjum SH, Ssebambulidde K, et al. Tocilizumab as a potential adjunctive therapy to corticosteroids in cryptococcal post-infectious inflammatory response syndrome (PIIRS): a report of two cases. J Clin Immunol, 2023, 43(8): 2146-2155.
104. Banz M, Schleenvoigt B, Eckardt N, et al. Successful management of severe IRIS associated with disseminated histoplasmosis in an HIV patient using cytokine adsorption therapy and JAK inhibition. AIDS Res Ther, 2025, 22(1): 123.

West China Medical Journal

Recommendations for antifungal therapy of mucormycosis from the Huaxi Mucormycosis Collaboration Network

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content