Mucormycosis is highly invasive and relentlessly progressive, with a mortality rate of >40%. The disease is usually categorized by the anatomic site involved.

• Rhinocerebral mucormycosis: In this, the most common form of the disease, pts initially have nonspecific symptoms that include eye or facial pain and facial numbness followed by the onset of conjunctival suffusion, blurry vision, and soft tissue swelling.
  • - If untreated, the infection can spread from the ethmoid sinus to the orbit, affecting extraocular muscle function and being associated with proptosis and chemosis.
  • - The visual appearance of infected tissue may progress from normal to erythematous to violaceous to a black necrotic eschar.
    • Pulmonary mucormycosis: In this second most common manifestation, pts typically present with fever, dyspnea, cough, and chest pain. Angioinvasion results in necrosis, cavitation, and/or hemoptysis. Differentiation from aspergillosis is critical as treatment regimens differ; the presence of ≥10 pulmonary nodules, pleural effusion, or concomitant sinusitis makes mucormycosis more likely.
    • Cutaneous mucormycosis: Caused by external implantation or hematogenous dissemination, necrotizing fasciitis due to mucormycosis has a mortality rate of ~80%.
    • Hematogenously disseminated mucormycosis: Infection can disseminate from any primary site of infection to any organ but most commonly metastasizes to the brain (with a mortality rate of ~100%).