死亡率取决于宿主和临床表现(例如,移植患者出现播散型疾病,而外伤接种后免疫功能正常的宿主出现皮肤型疾病)。未治疗病例死亡率为 97%。接受药物和手术联合治疗的患者死亡率降低至 30%。感染小克银汉霉属菌种和播散型疾病预示着治疗效果不良。[15]Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005;41:634-653.http://cid.oxfordjournals.org/content/41/5/634.fullhttp://www.ncbi.nlm.nih.gov/pubmed/16080086?tool=bestpractice.com
基于疾病类型的预期
局部性鼻窦型疾病的预后最好,死亡率 <10%。
接受移植的患者原发性皮肤性疾病的死亡率约为 30%。[44]Page AV, Evans AJ, Snell L, et al. Primary cutaneous mucormycosis in a lung transplant recipient: case report and concise review of the literature. Transpl Infect Dis. 2008;10:419-425.http://www.ncbi.nlm.nih.gov/pubmed/18627579?tool=bestpractice.com
肺部型疾病单纯内科治疗的死亡率为 55%,药物联合手术的死亡率为 27%。值得注意的是,近 30% 的患者是在尸检时做出诊断。[45]Lee FY, Mossad SB, Adal KA. Pulmonary mucormycosis: the last 30 years. Arch Intern Med. 1999;159:1301-1309.http://archinte.jamanetwork.com/article.aspx?articleid=485069http://www.ncbi.nlm.nih.gov/pubmed/10386506?tool=bestpractice.com
如果存在 CNS 扩散,鼻眶脑型毛霉病的死亡率>50%。[38]Arndt S, Aschendorff A, Echternach M, et al. Rhino-orbital-cerebral mucormycosis and aspergillosis: differential diagnosis and treatment. Eur Arch Otorhinolaryngol. 2009;266:71-76.http://www.ncbi.nlm.nih.gov/pubmed/18470529?tool=bestpractice.com
播散型疾病的预后最差,死亡率接近 100%。[1]Antachopoulos C, Gea-Banacloche JC, Walsh TJ. Zygomycosis (mucormycosis). In: Hospenthal DR, Rinaldi MG, eds. Diagnosis and treatment of human mycoses. New York, NY: Springer; 2008:227-243.