Zygomycosis is the broadest term to refer to infections caused by bread mold fungi of the zygomycota phylum. However, because zygomycota has been identified as polyphyletic, and is not included in modern fungal classification systems, the diseases that zygomycosis can refer to are better called by their specific names: mucormycosis (after Mucorales), phycomycosis (after Phycomycetes) and basidiobolomycosis (after Basidiobolus). These rare yet serious and potentially life-threatening fungal infections usually affect the face or oropharyngeal (nose and mouth) cavity. Zygomycosis type infections are most often caused by common fungi found in soil and decaying vegetation. While most individuals are exposed to the fungi on a regular basis, those with immune disorders (immunocompromised) are more prone to fungal infection. These types of infections are also common after natural disasters, such as tornadoes or earthquakes, where people have open wounds that have become filled with soil or vegetative matter. The condition may affect the gastrointestinal tract or the skin, often beginning in the nose and paranasal sinuses. It is one of the most rapidly spreading fungal infections in humans. Treatment consists of prompt and intensive antifungal drug therapy and surgery to remove the infected tissue. Symptoms and signs In the primary cutaneous form, the lesions are usually painful and necrotic, with black eschar, accompanied by a fever. Patients will usually present with a history of poorly controlled diabetes or malignancy. Myocutaneous infections may lead to amputation. Pulmonary tract infections seen with lung transplant patients, who are at high risk for fatal invasive mycoses. Rhinocerebral infection is characterized by paranasal swelling with necrotic tissues. Patient may have hemorrhagic exudates (tissue fluid from lesions tinged with blood) from the nose and eyes as the fungi penetrate through blood vessels and other anatomical structures. Causes Pathogenic zygomycosis is caused by species in two orders: Mucorales or Entomophthorales, with the former causing far more disease than the latter. These diseases are known as "mucormycosis" and "entomophthoramycosis", respectively. Order Mucorales (mucormycosis) Family Mucoraceae Absidia (Absidia corymbifera) Apophysomyces (Apophysomyces elegans and Apophysomyces trapeziformis) Mucor (Mucor indicus) Rhizomucor (Rhizomucor pusillus) Rhizopus (Rhizopus oryzae) Family Cunninghamellaceae Cunninghamella (Cunninghamella bertholletiae) Family Thamnidiaceae Cokeromyces (Cokeromyces recurvatus) Family Saksenaeaceae Saksenaea (Saksenaea vasiformis) Family Syncephalastraceae Syncephalastrum (Syncephalastrum racemosum) Order Entomophthorales (entomophthoramycosis) Family Basidiobolaceae Basidiobolus (Basidiobolus ranarum) Family Ancylistaceae Conidiobolus (Conidiobolus coronatus/Conidiobolus incongruus) Diagnosis Diagnosis is done with potassium hydroxide (KOH) preparation in tissue. On light microscopy, there will be broad, ribbon-like septate hyphae with 90