Disseminated mucormycosis
ICD-10 B46.4 · ICD-11 1F2C.1

Treatment of Disseminated Mucormycosis with Central Nervous System (Brain) Involvement

Clinical Scenario

This protocol covers disseminated mucormycosis presenting with central nervous system (brain) involvement — a severe manifestation that requires immediate, structured management to limit disease progression.

Treatment Approach (overview)

Management combines early surgical intervention — whenever feasible — with immediate systemic antifungal therapy started without delay from day one. The complete dosing strategy, course duration, and criteria for transitioning to oral therapy are specified in the full protocol.

Treatment Goals

The aim is to reach stable disease or partial response, with resolution of the signs and symptoms of infection and substantial radiographical improvement, evaluated by regular scheduled imaging.

Instant Access to Structured Evidence-Based Regimens

References

  1. In CNS involvement, animal models and the above observations support use of liposomal amphotericin B at 10 mg/kg per day.
  2. The guideline group strongly supports an early complete surgical treatment for mucormycosis whenever possible, in addition to systemic antifungal treatment.
  3. Doses should not be slowly increased over several days; rather, the full daily dose should be given from the first treatment day.
  4. When switching to oral treatment, use of isavuconazole or posaconazole delayed release tablets is strongly supported.
  5. In view of the rapid progress of mucormycosis, weekly CT scans are strongly recommended, particularly in unstable patients.
  6. Therapy can be continued until resolution of signs and symptoms of infection, and substantial radiographical improvement.
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