Mucormycosis. A complication of critical care

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Abstract
Lethal nosocomial mucormycosis developed in 3 previously well individuals while they were receiving intensive care for acute hemorrhagic pancreatitis, cardiogenic shock, and a ruptured intra-abdominal aortic aneurysm. In 2 cases, the condition was first seen as progressive cavitary pneumonia refractory to antibacterial therapy; Mucoraceae was identified in all 3 patients only at autopsy. Each patient received large doses of corticosteroids and broad-spectrum antibiotics, and all suffered from respiratory failure, acute renal failure with acidosis and severe hyperglycemia in association with total parenteral nutrition. Mucoraceae should be regarded as an additional nosocomial pathogen in the setting of advanced life-support care.