Unveiling mucormycosis in Brazil: Analysis of 298 cases using amphotericin B distribution data - 28/03/26
, Sinaida Teixeira Martins b, Maria Adelaide Millington b, William Kazunori Sekiguchi a, Adriana Satie Gonçalves Kono Magri a, c, Vítor Falcão de Oliveira a, c, Marcello Mihailenko Chaves Magri aAbstract |
Background : Since mucormycosis is not a notifiable disease in Brazil, its true incidence is likely underestimated; this study aims to assess its prevalence and characterize its epidemiological, clinical, and laboratory features. Methods: We conducted a retrospective observational study of patients with mucormycosis treated with lipid amphotericin B (AmB) across 156 public healthcare centers in Brazil from 2017 to 2023, using Ministry of Health data. Results: There were 305 AmB distributions for 298 patients: 230 (75 %) lipid complex (ABLC) and 75 (25 %) liposomal formulations (LAmB). The highest number of distributions occurred in 2021 (80/298, 27 %). The median age was 52 years (IQR 33–63), with 65 % male patients. The main comorbidity was diabetes mellitus (42 %), followed by oncohematologic conditions (25 %). Most cases presented with the rhinocerebral (ROC) form (66 %), followed by pulmonary (15 %) and gastrointestinal (5 %). The ROC form predominated among patients with diabetes and COVID-19 ( > 80 %), while the pulmonary form was more common in solid-organ transplant and HSCT patients (33 % and 27 %, respectively). Histopathology established the diagnosis in 64 % of cases, with Rhizopus spp. causing the majority of infections (31/53, 58 %). The mean AmB dose was 5 mg/kg/day (IQR 1–10.8). Patients with gastrointestinal forms were significantly younger ( p = 0.007), and AmB doses did not differ significantly across clinical forms ( p = 0.3). Conclusion : This study details the Brazilian mucormycosis patient profile, highlighting predominant diabetes-associated cases, the shift from ABLC to LAmB use after 2021, the predominance of the ROC form, pulmonary involvement in immunosuppressed patients, and regional diagnostic disparities.
Le texte complet de cet article est disponible en PDF.Keywords : Mucormycosis, Mucorales, Brazil, Amphotericin B
Plan
Vol 36 - N° 2
Article 101619- juin 2026 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?
