Skip to main content

Mucorales RT-PCR: A potential game changer in diagnosis of Mucormycosis

Mucormycosis refers to severe infectious diseases that are caused by filamentous fungi of the Mucorales order that primarily affect immunocompromised patients and patients with diabetes mellitus. Recently, an increasing incidence has been reported among COVID-19 patients in India. The most common genera in invasive mucormycosis are Rhizopus, Rhizomucor, Lichtheimia and Mucor, accounting for 90% of all cases.

Clinically and radiographically, mucormycosis is often indistinguishable from other invasive fungal infections such as aspergillosis and remains difficult to diagnose. A definitive diagnosis of mucormycosis typically requires histopathological evidence or positive fungal culture from a specimen from the site of infection, which may be difficult to obtain in some patients.

A molecular diagnostic approach, detecting circulating DNA of Mucorales (by PCR) in serum of patients, may help to diagnose invasive mucormycosis more quickly and to introduce directed therapy earlier and eventually monitor treatment. Bronchoalveolar lavage (BAL), tracheal aspiration, sputum, pleural fluid, biopsy samples can also be used for the detection of Mucorales DNA. The sensitivity of Mucorales PCR from blood is inferior when compared to a Mucorales PCR performed on tissue samples (because the sampling is close to the site of fungal growth), but it is still largely acceptable. Mucorales PCR performed on blood present the advantage of being totally non-invasive. Mucorales spp detection depends on the collection of high-quality specimens, their rapid transport to the laboratory, and appropriate storage before laboratory testing.

Negative results do not necessarily indicate absence of mucorales infection. Positive results do not exclude co-infection with other pathogens. Other laboratory testing and assessment of clinical presentation must be included in the final diagnosis.

Early specific diagnosis and prompt therapeutic intervention with active antifungal treatment such as Amphotericin B are essential for improving the outcome of mucormycosis.

- Dr Prashant Goyal


Popular posts from this blog

Diagnosis of Celiac disease

Coeliac disease is an autoimmune disease where the lining of the small intestine is damaged by exposure to gluten (a protein found in grains such as wheat, rye, barley and oats) in genetically predisposed children and adults. The reaction to gluten causes inflammation and atrophy of intestinal lining, which can lead to malabsorption of nutrients and related health issues. The diagnosis of Celiac disease is classically based on a combination of findings from a patient’s clinical history, serologic testing and duodenal biopsies. SEROLOGY TEST: Serologic tests are for screening purposes and do not confirm the diagnosis of coeliac disease. Serologic tests for celiac disease include anti-transglutaminase IgA & IgG antibody, anti-endomysium IgA antibody, and Deamidated Gliadin Peptide IgA & IgG antibodies.  The serologic tests that check for IgA antibodies are more sensitive for celiac disease than the tests for IgG antibodies. However, in people who have IgA deficiency, IgG tests ma

Hepatitis Markers

  Hepatitis means inflammation of the liver. It is commonly the result of a viral infection (hepatitis viruses A, B, C, D, and E), but there are other possible causes of hepatitis like autoimmune hepatitis and hepatitis that occurs as a secondary to medications, drugs, toxins, and alcohol. Hepatitis markers (Antigens, Antibodies & PCR) are useful for determining diagnosis, appropriate treatment, and vaccination status and for monitoring treatment.  Viral Hepatitis Markers: Hepatitis A virus-IgM Antibodies (anti-HAV IgM) : Serum IgM antibody to the hepatitis A virus (antiHAV) appears at about four weeks after initial infection and usually persists for 2-6 months as the initial phase of the immune response. (Test code H018) Hepatitis A virus-IgG Antibodies (anti-HAV IgG) : Serum IgG antibody to HAV generally persists for lifetime, conferring immunity to further HAV infection. (Test code H017) Hepatitis A virus-Total Antibodies (Anti-HAV-Total Ab) : The total HAV antibody test detect