1. Fungi causing Subcutaneous Zygomycosis.
Order Mucorales
Order Entomophthorales
Acute
Chronic

2. Zygomycosis (Mucorales).
Mucorales infections Definition:
Angiotropic (blood vessel-invading)
The most common genera causing disease are:
Rhizopus
Rhizomucor
Mucor
Absidia
Fast growing non-septate molds

3. Geographical distribution & normal habitat
World-wide
Soil and decomposing organic matter
Found in outdoor and indoor air
Food and dust
Clinical forms
The infection typically involves the:
Rhino-facial-cranial area
Lungs, gastrointestinal tract or skin
Other parts can also be affected

4. Risk factors
The disease is associated with:
Diabetic ketoacidosis
Malnourished children
Severely burned patients
It is also seen in patients with
Leukemia
Lymphoma
AIDS
In patients using corticosteroids

5. Laboratory diagnosis
Specimens:
Aspirated material from sinuses
Sputum in pulmonary disease
Biopsy material
Management of mucormycosis
The prognosis is bad
Most cases of gastric and pelvic disease are diagnosed at autopsy
Cases occurred in patients with pulmonary disease, leukemia, or with lymphomas, are usually fatal
Control of the diabetes, aggressive surgical debridement of involved tissue, and high doses of Amphotericin B are recommended

6. 2- Zygomycosis Order Entomophthorales
Entomophthorales infections
Causes subcutaneous zygomycosis
Known as Entomophthoromycosis
Tow genera are involved:
Conidiobolus
Basidiobolus
Infections are:
Chronic
Slowly progressive
Restricted to the subcutaneous tissue

7. Not like Mucorales:
No vascular invasion or infarction
Chronic inflammatory response
Basidiobolus infection
Chronic inflammatory or granulomatous disease
Subcutaneous tissue of the limbs, chest, back or buttocks
Mostly in children (predominance in males)

8. Conidiobolus infection
Chronic inflammatory or granulomatous disease
Nasal submucosa
Characterized by polyps or palpable subcutaneous masses
Occur mainly in adult (80% of cases)
Laboratory diagnosis
Specimens:
Aspirated material from sinuses
Biopsy material

9. The following steps are used for the both types of Zygomycosis:
10 or 20% KOH:
Typically contain thick-walled aseptate hyphae
Swollen cells (up to 50 um) and distorted hyphae may be present
Culture:
SDA without cycloheximide at 30°C
Rapid growth
3- A diagnosis can also be made by examining a biopsy for granuloma formation and the presence of aseptate hyphae, eosinophils, neutrophils, and fibroblasts. Tissue for culture should be send in a dry sterile container, and biopsies should be fixed and send in formal saline.

10. Sporangium containing sporangiospores

11. Spherical, brown zygospores formed between opposite suspensors
Spherical, brown zygospores formed between opposite suspensors. Also, present sporangiola.

12. Typical colony on Sabouraud glucose agar at 25C

13. Hyphae in lung tissue

14. Hyaline sparsely septate hyphae biopsy specimen of palate.

15. A peach, which has been colonized by Rhizopus sp

16. A gastric proliferative mycosis in a chicken caused by Rhyzopus arrhizus

17. Wide, sparsely-septate hyphae and striated sporangiospores

18. Non-septate (coenocytic) hyphal strand characteristic of the fungi belonging to the Zygomycetes