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Mucormycoses are caused by moulds of the orders Mucorales and Entomophthorales. These fungi are ubiquitous in nature and are transmitted via inhalation, ingestion, or traumatic inoculation. Infections occur almost exclusively in immunosuppressed patients. Patients with diabetes mellitus are a particular group at risk. Mucormycoses can cause cutaneous, gastrointestinal, or pulmonary disease. In diabetic patients, rapidly progressive sinu-orbito-cerebral infection is typical, often leading to loss of central vision. Mucormycosis is frequently lethal due to delayed diagnosis. The purpose of this article is to provide an overview of mucormycosis, while focusing on patients with diabetes mellitus. The European guideline on the diagnosis and management of mucormycosis as well as selected current literature on the topic were reviewed for this article. Mucormycosis is an ultra-orphan disease associated with high mortality. Aggressive, invasive fungal growth often exceeds organ boundaries. The drug of choice for first-line therapy is liposomal amphotericin B. In the case of treatment failure, switching to or the addition of posaconazole should be considered. Isavuconazole, a well-tolerated alternative drug, has also been available since 2016. Ongoing clinical trials are currently focusing on new antifungal drugs and immunotherapy as a novel approach of treatment. Furthermore, investigations are underway to determine whether combining different drugs improves efficacy.

Mucormycoses are caused by moulds of the orders Mucorales and Entomophthorales. These fungi are ubiquitous in nature and are transmitted via inhalation, ingestion, or traumatic inoculation. Infections occur almost exclusively in immunosuppressed patients. Patients with diabetes mellitus are a particular group at risk. Mucormycoses can cause cutaneous, gastrointestinal, or pulmonary disease. In diabetic patients, rapidly progressive sinu-orbito-cerebral infection is typical, often leading to loss of central vision. Mucormycosis is frequently lethal due to delayed diagnosis. The purpose of this article is to provide an overview of mucormycosis, while focusing on patients with diabetes mellitus. The European guideline on the diagnosis and management of mucormycosis as well as selected current literature on the topic were reviewed for this article. Mucormycosis is an ultra-orphan disease associated with high mortality. Aggressive, invasive fungal growth often exceeds organ boundaries. The drug of choice for first-line therapy is liposomal amphotericin B. In the case of treatment failure, switching to or the addition of posaconazole should be considered. Isavuconazole, a well-tolerated alternative drug, has also been available since 2016. Ongoing clinical trials are currently focusing on new antifungal drugs and immunotherapy as a novel approach of treatment. Furthermore, investigations are underway to determine whether combining different drugs improves efficacy.