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Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Case Report

Primary Cutaneous Mucormycosis: A Necrotising Soft Tissue Infection with Poor Prognosis

Author(s): Poornima Dogra, Nidhi Singla*, Robin Kaushik, Simrandeep Singh and Varsha Gupta

Volume 23, Issue 6, 2023

Published on: 26 May, 2023

Article ID: e040523216523 Pages: 5

DOI: 10.2174/1871526523666230504114801

Price: $65

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Abstract

Background: Cutaneous mucormycosis is an unusual fungal infection that continues to occur. It needs aggressive surgical debridement and timely administration of antifungals due to its high fatality rate. High clinical suspicion on the part of a surgeon is required to prevent the same.

Case Presentation: We present two cases of cutaneous mucormycosis in which the patients succumbed to death, highlighting the seriousness of the condition. One patient had a lower leg ulcer and was diabetic, and the other patient had a gluteal abscess following an intramuscular injection. Tissue samples grew Rhizopus arrhizus and Apophysomyces sp., respectively. Both patients were treated with amphotericin B, and extensive debridement was performed.

Discussion: Cutaneous mucormycosis can be reported in immunocompetent people, and there is a need for early recognition of the entity as a differential diagnosis of any nonhealing necrotic ulcer.

Conclusion: Proper training and education of technical and clinical staff should be done at peripheral primary and secondary care centres so as not to miss out on cases of mucormycosis and for better prognosis in a cutaneous variety of mucormycosis in surgical patients.

Graphical Abstract

[1]
Prakash H, Chakrabarti A. Epidemiology of mucormycosis in India. Microorganisms 2021; 9(3): 523.
[http://dx.doi.org/10.3390/microorganisms9030523] [PMID: 33806386]
[2]
Weinhold B. Rare fungal illness follows tornado. Environ Health Perspect 2013; 121(4): A116.
[http://dx.doi.org/10.1289/ehp.121-a116] [PMID: 23548439]
[3]
Suthananthan AE, Koek SA, Sieunarine K. Cutaneous mucormycosis in an immunocompromised patient: A case report. J Surg Case Rep 2017; 2017(3): rjx056.
[http://dx.doi.org/10.1093/jscr/rjx056] [PMID: 28458862]
[4]
Chander J, Kaur M, Singla N, et al. Cano-Lira JF, Guarro J. Mucormycosis: Battle with the deadly enemy over a five-year period in India. J Fungi 2018; 4(2): 46.
[http://dx.doi.org/10.3390/jof4020046] [PMID: 29642408]
[5]
Skiada A, Pavleas I, Drogari-Apiranthitou M. Epidemiology and diagnosis of mucormycosis: An update. J Fungi 2020; 6(4): 265.
[http://dx.doi.org/10.3390/jof6040265] [PMID: 33147877]
[6]
Bellazreg F, Hattab Z, Meksi S, et al. Outcome of mucormycosis after treatment: Report of five cases. New Microbes New Infect 2015; 6: 49-52.
[http://dx.doi.org/10.1016/j.nmni.2014.12.002] [PMID: 26137308]
[7]
Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: Pathophysiology, presentation, and management. Clin Microbiol Rev 2005; 18(3): 556-69.
[http://dx.doi.org/10.1128/CMR.18.3.556-569.2005] [PMID: 16020690]
[8]
Chang H, Wang PN, Huang Y. Cutaneous mucormycosis. Infection 2018; 46(6): 901-2.
[http://dx.doi.org/10.1007/s15010-018-1179-4] [PMID: 30091018]
[9]
Kaushik R. Primary cutaneous zygomycosis in India. Indian J Surg 2012; 74(6): 468-75.
[http://dx.doi.org/10.1007/s12262-012-0429-4] [PMID: 24293901]
[10]
Tilak R, Gupta MK, Kumar N, Dhameja N, Sharma A. Laboratory diagnosis of mucormycosis: Present perspective. J Family Med Prim Care 2022; 11(5): 1664-71.
[http://dx.doi.org/10.4103/jfmpc.jfmpc_1479_21] [PMID: 35800582]
[11]
Badiee P, Arastefar A, Jafarian H. Comparison of histopathological analysis, culture and polymerase chain reaction assays to detect mucormycosis in biopsy and blood specimens. Iran J Microbiol 2013; 5(4): 406-10.
[PMID: 25848513]
[12]
Skiada A, Lass-Floerl C, Klimko N, Ibrahim A, Roilides E, Petrikkos G. Challenges in the diagnosis and treatment of mucormycosis. Med Mycol 2018; 56: S93-S101.
[http://dx.doi.org/10.1093/mmy/myx101] [PMID: 29538730]
[13]
Castrejón-Pérez AD, Welsh EC, Miranda I, Ocampo-Candiani J, Welsh O. Cutaneous mucormycosis. An Bras Dermatol 2017; 92(3): 304-11.
[http://dx.doi.org/10.1590/abd1806-4841.20176614] [PMID: 29186239]
[14]
Roden MM, Zaoutis TE, Buchanan WL, et al. Epidemiology and outcome of zygomycosis: A review of 929 reported cases. Clin Infect Dis 2005; 41(5): 634-53.
[http://dx.doi.org/10.1086/432579] [PMID: 16080086]
[15]
Jeong W, Keighley C, Wolfe R, et al. The epidemiology and clinical manifestations of mucormycosis: A systematic review and meta-analysis of case reports. Clin Microbiol Infect 2019; 25(1): 26-34.
[http://dx.doi.org/10.1016/j.cmi.2018.07.011] [PMID: 30036666]
[16]
Abdollahi A, shokohi T, Amirrajab N, et al. Clinical features, diagnosis, and outcomes of rhino-orbito-cerebral mucormycosis: A retrospective analysis. Curr Med Mycol 2016; 2(4): 15-23.
[http://dx.doi.org/10.18869/acadpub.cmm.2.4.15] [PMID: 28959791]
[17]
Gomes MZR, Lewis RE, Kontoyiannis DP. Mucormycosis caused by unusual mucormycetes, non-Rhizopus, Mucor, and Lichtheimia species. Clin Microbiol Rev 2011; 24(2): 411-45.
[http://dx.doi.org/10.1128/CMR.00056-10] [PMID: 21482731]
[18]
Tragiannidis A, Groll AH. Hyperbaric oxygen therapy and other adjunctive treatments for zygomycosis. Clin Microbiol Infect 2009; 15: 82-6.
[http://dx.doi.org/10.1111/j.1469-0691.2009.02986.x] [PMID: 19754764]
[19]
Saraiya HA. Successful management of cutaneous mucormycosis by delaying debridement. Ann Plast Surg 2011; 28: 164-16620.
[PMID: 21629068]

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