Table 3 Caveats in the management of mucormycosis (including CAM)

Delaying treatment with amphotericin B in patients with hematological malignancies for >5 days causes about 2-fold increase in 12-week mortality.

[10]

The duration of active antifungal treatments has not been established yet, but weeks to months are generally advised.

[26]

Delaying surgery and the presence of multiorgan failure impede imaging procedures for COVID-19 patients with mucormycosis.

[62]

It is impossible to perform surgery in disseminated mucormycosis or when infection reaches lung parenchyma next to large vessels or some parts of the brain.

[26]

Mucoraceous fungi exhibit in-vitro resistance to most antifungals, including voriconazole.

[73,74,75, 79]

First-line treatment failure arises due to drug intolerance or refractory mucormycosis.

[16]

Assessment of treatment response may be difficult due to postoperative changes and scarring.

[16]

Isavuconazole can shorten the corrected QT (QTc) interval although it is less hepatotoxic.

[80,81,82]

Hyperbaric oxygen should be used cautiously due to the unavailable supportive clinical data.

[69, 70]