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Resumen Antecedentes La descripción antiguamente más frecuente de la mucormicosis era la afectación nasosinusal en pacientes con cetoacidosis diabética. Sin embargo, en los últimos años han surgido nuevos grupos de pacientes con riesgo de mucormicosis. Objetivos y métodos Se realizó un análisis retrospectivo de las características, tratamiento y evolución de los pacientes con mucormicosis en nuestro hospital (años 2012-2016). Resultados De los 12 pacientes del estudio, siete padecían alguna enfermedad hematológica como factor predisponente, la mayoría (6 pacientes) por trasplante de progenitores hematopoyéticos. Solamente un paciente estaba en cetoacidosis diabética. Siete pacientes del total estaban recibiendo antifúngicos al inicio de los síntomas, y 9 pacientes los habían recibido los tres meses previos. La afectación fue rinosinusal (16,6%), pulmonar localizada (33,3%), musculoesquelética (25%) y diseminada (25%). En 8 pacientes se realizó desbridamiento quirúrgico. Seis pacientes recibieron tratamiento combinado con anfotericina B y posaconazol (mortalidad de grupo 16%), y 4 pacientes fueron tratados con anfotericina B en monoterapia (mortalidad 50%), con una mortalidad global del 41%. La mortalidad de los pacientes con afectación pulmonar fue del 71%, y en el caso de enfermedad diseminada del 100%. Ningún paciente con afectación únicamente musculoesquelética falleció. Conclusiones La mucormicosis sigue teniendo una elevada mortalidad, especialmente las formas pulmonares. Las formas musculoesqueléticas tuvieron mejor pronóstico. El grupo de riesgo principal fue el de los pacientes con trasplante de médula ósea. El tratamiento combinado obtuvo mejores resultados que la monoterapia, aunque se necesita más experiencia para definir el tratamiento más adecuado. Abstract Background The most common presentation of mucormycosis in the past was the nasosinusal involvement in patients with diabetic ketoacidosis. However, in the last few years, new groups of patients with risk of mucormycosis have emerged. Aims and methods Retrospective analysis of the characteristics, treatment and evolution of patients with mucormycosis in a tertiary hospital in the years 2012-2016. Results Of the 12 patients included in the study, 7 had a haematological disease as a predisposing factor, most of them (6 patients) related to transplantation of haematopoietic progenitors. Only one patient had diabetic ketoacidosis. Seven out of the twelve patients were receiving an antifungal treatment at the onset of symptoms, and 9 patients had received them three months before. The clinical presentation was rhinosinusal (16.6%), localised lung disease (33.3%), and musculoskeletal (25%) and disseminated disease (25%). Surgical debridement was performed on 8 patients. Combination therapy with amphotericin B and posaconazole was received by 6 patients (16% mortality), and 4 patients were treated with amphotericin B alone (50% mortality), with an overall mortality of 41%. The mortality of patients with pulmonary involvement was 71%, increasing to 100% in the case of disseminated disease. None of the patients with only musculoskeletal involvement died. Conclusions Mucormycosis has a high mortality rate, especially the pulmonary forms. Musculoskeletal involvement had a better prognosis. The main group at risk was that of patients with haematopoietic stem cell transplantation. Combination therapy had better results than monotherapy, although more experience is needed to define the most appropriate treatment. [ABSTRACT FROM AUTHOR]

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