Mucormycosis vs aspergillosis

Last revised by Daniel J Bell on 8 Jul 2021

It is important to be able to distinguish between mucormycosis and aspergillosis because:​

  • antifungal sensitivity: mucormycosis is resistant to voriconazole, whilst aspergillosis is sensitive to it
  • mucormycosis may have an improved prognosis if treated earlier

It is to be noted that there has been a rise of mucormycosis in the second wave of the COVID-19 pandemic in India attributed to uncontrolled diabetes mellitus and overzealous use of steroids.

Clinical presentation

Unfortunately, there is a marked overlap in the clinical presentations of the two conditions, such that they cannot be confidently distinguished. The following symptoms are variably seen in both fungal infections 5,6:

  • massive, potentially fatal, hemoptysis
    • invasion of the major pulmonary blood vessels by hyphae
  • organ invasion by hyphae infiltrating through tissue planes

Practical points

Imaging features that favor mucormycosis over aspergillus lung infection in a neutropenic patient are 1-4:

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