Brazilian task force for the management of mucormycosis

Author: mycolabadmin
9/19/2025
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Summary

Mucormycosis is a rare but deadly fungal infection that has been increasingly reported in Brazil, especially during the COVID-19 pandemic. This Brazilian medical task force developed practical guidelines for diagnosing and treating this serious infection, which primarily affects people with uncontrolled diabetes or weakened immune systems. The key to survival is early diagnosis combined with aggressive surgery and specific antifungal medications, along with controlling blood sugar and immune system suppression.

Background

Mucormycosis is a rare but life-threatening fungal infection caused by fungi of the order Mucorales, with increased incidence in Brazil particularly during the COVID-19 pandemic. The infection predominantly affects immunocompromised patients and those with uncontrolled diabetes mellitus, with mortality rates ranging from 25% to 80%. In Brazil, 311 cases were reported between 2010 and 2021, with 85 cases occurring during the pandemic.

Objective

To provide evidence-based, context-specific guidelines for the diagnosis and management of mucormycosis within the Brazilian healthcare system. The guidelines aim to address diagnosis, treatment strategies, and management of underlying risk factors to reduce the disease burden in Brazil and serve as reference for other middle-income countries.

Results

The review identified Rhizopus arrhizus as the most prevalent species globally. Rhino-orbito-cerebral disease is the predominant form in Brazil. Key recommendations include early aggressive surgical debridement combined with liposomal amphotericin B (5-10 mg/kg/day) for induction therapy, followed by isavuconazole or posaconazole for sequential therapy, with strict control of hyperglycemia and immunosuppression as essential adjunctive measures.

Conclusion

Standardized national guidance, improved rapid diagnostics, systematic surveillance, and equitable drug availability are critical to reduce Brazil’s mucormycosis burden. The Brazilian Ministry of Health’s incorporation of isavuconazole and expanded access to liposomal amphotericin B represents significant progress in evidence-based management of this severe opportunistic infection.

Published in:Brazilian Journal of Infectious Diseases,
Study Type:Narrative Review,
Source: PMID: 40974632, DOI: 10.1016/j.bjid.2025.104579