Oliver A. CornelyAna Alastruey-IzquierdoDorothee ArenzSharon C.A. ChenEric DannaouiBruno HochheggerMartin HoeniglHenrik E. JensenKatrien LagrouRussell E. LewisSibylle C. MellinghoffMervyn MerZoi D. PanaDanila SeidelDonald C. SheppardRoger WahbaMurat AkovaAlexandre AlanioAbdullah M.S. Al-HatmiSevtap Arikan-AkdagliHamid BadaliRonen Ben-AmiAlexandro BonifazStéphane BretagneElio CastagnolaMethee ChayakulkeereeArnaldo L. ColomboDora E. Corzo-LeónLubos DrgonaAndreas H. GrollJesus GuineaClaus Peter HeusselAshraf S. IbrahimSouha S. KanjNikolay KlimkoMichaela LacknerFrederic LamothFanny LanternierCornelia Lass-FloerlDong Gun LeeThomas LehrnbecherBadre E. LmimouniMihai MaresGeorg MaschmeyerJacques F. MeisJoseph MeletiadisC. Orla MorrisseyMarcio NucciRita OladeleLivio PaganoAlessandro PasqualottoAtul PatelZdenek RacilMalcolm RichardsonEmmanuel RoilidesMarkus RuhnkeSeyedmojtaba SeyedmousaviNeeraj SidharthanNina SinghJános SinkoAnna SkiadaMonica SlavinRajeev SomanBrad SpellbergWilliam SteinbachBan Hock TanAndrew J. UllmannJörg J. VehreschildMaria J.G.T. VehreschildThomas J. WalshP. Lewis WhiteNathan P. WiederholdTheoklis ZaoutisArunaloke ChakrabartiManchester University NHS Foundation TrustDuke University Medical CenterPublic Health WalesUniversidade Federal de Ciencias da Saúde de Porto AlegreFondazione Policlinico Universitario Agostino Gemelli IRCCS Università Cattolica del Sacro CuoreMinistry of Health OmanAmerican University of Beirut Medical CenterSzent Laszlo HospitalHospital General Universitario Gregorio MarañonCancer Research Institute of Slovak Academy of SciencesPeter Maccallum Cancer CentreUniversitätsklinikum WürzburgErasmus MCKU Leuven– University Hospital LeuvenHopital Europeen Georges-PompidouKøbenhavns UniversitetUniversity of California, San DiegoThe Children's Hospital of PhiladelphiaUniversity of Southern CaliforniaUniversite Paris DescartesNational and Kapodistrian University of AthensNijmegen Interdenominational Hospital Canisius-WilhelminaAlma Mater Studiorum Università di BolognaUniversidad Complutense de MadridUniversity of MelbourneCentro Nacional de MicrobiologiaThe University of SydneyUniversité Paris-SudUniversity of CologneUniversity of Lagos College of MedicineLukas-KrankenhausCentre Hospitalier Universitaire VaudoisP.D. Hinduja National Hospital and Medical Research CentreMonash UniversityMohammed V University in RabatUniversity of Texas Health Science Center at San AntonioNew York Presbyterian HospitalSingapore General HospitalNorth-Western State Medical University named after I.I. MechnikovMazandaran University of Medical SciencesKlinikum Ernst von BergmannNational Institute of Allergy and Infectious DiseasesUniversity of WitwatersrandHarbor-UCLA Medical CenterIRCCS Istituto Giannina Gaslini - Ospedale PediatricoUniversity of AberdeenPontificia Universidade Catolica do Rio Grande do SulHospital General de MexicoAristotle University of ThessalonikiUniversidade Federal de Sao PauloUniversity of Pittsburgh Medical CenterHacettepe University, Faculty of MedicineFaculty of Medicine, Siriraj Hospital, Mahidol UniversityTel Aviv Sourasky Medical CenterUniklinik KölnMedizinische Universitat InnsbruckAmrita Institute of Medical Sciences IndiaGoethe-Universität Frankfurt am MainUniversitätsklinikum MünsterMedizinische Universität GrazTel Aviv University, Sackler Faculty of MedicineUniversity of ManchesterHippokration General HospitalHospital General "Dr. Manuel Gea González"Universitätsklinikum HeidelbergThe Catholic University of KoreaMcGill UniversityInstitute of Hematology and Blood TransfusionPostgraduate Institute of Medical Education & Research, ChandigarhUniversidade Federal do Rio de JaneiroCenter of Expertise in MicrobiologyWesterdijk Fungal Biodiversity InstituteGerman Center for Infection Research (DZIF), Partner Site Bonn-CologneIon Ionescu de la Brad UniversityVedanta Institute of Medical Sciences2020-01-272020-01-272019-12-01The Lancet Infectious Diseases. Vol.19, No.12 (2019), e405-e42114744457147330992-s2.0-85075522537https://repository.li.mahidol.ac.th/handle/20.500.14594/51296© 2019 Elsevier Ltd Mucormycosis is a difficult to diagnose rare disease with high morbidity and mortality. Diagnosis is often delayed, and disease tends to progress rapidly. Urgent surgical and medical intervention is lifesaving. Guidance on the complex multidisciplinary management has potential to improve prognosis, but approaches differ between health-care settings. From January, 2018, authors from 33 countries in all United Nations regions analysed the published evidence on mucormycosis management and provided consensus recommendations addressing differences between the regions of the world as part of the “One World One Guideline” initiative of the European Confederation of Medical Mycology (ECMM). Diagnostic management does not differ greatly between world regions. Upon suspicion of mucormycosis appropriate imaging is strongly recommended to document extent of disease and is followed by strongly recommended surgical intervention. First-line treatment with high-dose liposomal amphotericin B is strongly recommended, while intravenous isavuconazole and intravenous or delayed release tablet posaconazole are recommended with moderate strength. Both triazoles are strongly recommended salvage treatments. Amphotericin B deoxycholate is recommended against, because of substantial toxicity, but may be the only option in resource limited settings. Management of mucormycosis depends on recognising disease patterns and on early diagnosis. Limited availability of contemporary treatments burdens patients in low and middle income settings. Areas of uncertainty were identified and future research directions specified.Mahidol UniversityMedicineReviewSCOPUS10.1016/S1473-3099(19)30312-3