Clinical predictors of mucormycosis in children with type 1 diabetes mellitus.

BACKGROUND

Mucormycosis is an acute, often rapidly fatal fungal infection that is an important cause of death in young patients with diabetes mellitus (DM) who have poor glycemic control and acute ketosis. Despite the importance of this condition, the clinical predictors of mucor infection are not well defined.

METHODS

A retrospective chart review was carried out for five patients, age 14-19 years, diagnosed with mucormycosis at the University of Florida between 1984 and 1999. For the three patients for whom adequate information was available, two randomly selected, age-matched case controls were selected and compared to affected patients for the following variables: average HbA1c concentrations, number of missed clinic appointments, and the number of hospital and Diabetes Project Unit (DPU) admissions.

RESULTS

HbA1c levels were similar in affected patients and controls, indicating glycemic control is not the principal factor predisposing to mucor infection. African-American race and poor compliance, as evidenced by poor clinic attendance, risk-taking behaviors and high admission rate to the DPU, were predictors of increased susceptibility to infection with mucormycosis.