{"hq_id":"hq-c-mix-000088","name":"Mucor/Rhizopus (Mucormycosis agents)","context":"human_adult","risk_level":"extreme","schema":"legacy","note":"Synthesis unavailable: compound lacks vectorizable regulatory classifications. Raw safety data returned.","data":{"risk_level":"extreme","summary":"Mucor and Rhizopus species (order Mucorales) are the primary causative agents of mucormycosis (formerly zygomycosis), an aggressive, rapidly progressive fungal infection with 50% overall mortality. The COVID-19-associated mucormycosis (CAM) surge in India in 2021 was catastrophic: >45,000 cases reported, primarily rhino-orbito-cerebral mucormycosis in patients with diabetes, corticosteroid use, and recent SARS-CoV-2 infection. Key virulence: Mucorales have unique affinity for endothelial cells via the glucose-regulated protein 78 (GRP78) receptor; in hyperglycemic, acidotic conditions (diabetic ketoacidosis), free iron increases dramatically, promoting Mucorales growth (iron acquisition via rhizoferrin). Clinical forms: rhino-orbito-cerebral (most common, 40% mortality), pulmonary (60-80% mortality), cutaneous (trauma/burns), disseminated (>90% mortality), and gastrointestinal. Angioinvasion causes tissue necrosis (characteristic black eschar). Treatment requires ALL THREE: (1) surgical debridement of necrotic tissue, (2) high-dose amphotericin B (only effective antifungal — azoles are INEFFECTIVE), and (3) reversal of underlying predisposition (glycemic control, immunosuppression reduction). Isavuconazole is the only azole with Mucorales activity. Delay in treatment >6 days doubles mortality.","source_refs":["aletheia_fungi_batch_2026"]},"meta":{"synthesis_version":"n/a","timestamp":"2026-05-13T22:19:36.382Z"}}