Primary mucormycosis of abdominal wall: A rare fungal infection in a immunocompetent patient (original) (raw)
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Successful surgical management of primary abdominal wall mucormycosis in an immunocompetent patient
2021
Primary abdominal wall mucormycosis rarely occur in immunocompetent, non-diabetic patients but may affectin patients with traumatic injury with contaminated wounds and patients underlying malignancies usually infiltrating into skin. Herein we are reporting a case of primary cutaneous mucormycosis in a 17-year-old male without immunodeficiency or any comorbidity. He was managed with multiple debridement of the wound and intravenous amphotericin B therapy with cumulative dose of 2000 mg of liposomal amphotericin B followed by split skin grafting. We would like to emphasize the importance of high index of suspicionof fungal sepsis and early start of antifungal therapy in this condition can reduce high rate of mortality and management of large wound with split skin grafting in same setting to avoid morbidity.
Primary cutaneous mucormycosis: a diagnosis to consider
Journal of the European Academy of Dermatology and Venereology, 1999
Primary cutaneous mucormycosis is a deep fungal infection, mainly seen in diabetics and immunocompromised subjects. Rapid diagnosis and therapy are necessary to avoid fatal outcome. We describe the complete histopathological and microbiological studies of primary cutaneous mucormycosis in a 74-year-old man with several risk factors, such as chronic obstructive pulmonary disease, respiratory acidosis, hemolytic anemia, myelodysplastic syndrome and iatrogenic diabetes, due to corticosteroid therapy. He developed two cutaneous necrotic scars on his left leg. Mucormycosis was suspected and specimens from surgical dkbridement were histopathologically and microbiologically studied confirming the clinical diagnosis. Amphotericin B was given topically and intravenously resulting in complete healing of the ulcer. Risk factors and microbiological studies are compared with those in the current literature. It is necessary in certain cases to suspect mucormycosis infections in diabetics, immunocompromised subjects and even in healthy individuals. Rapid diagnosis and treatment are important, but they should be based on complete histopatholgical and microbiological studies, to establish the genus of the causal agent.
Cutaneous mucormycosis in an immunocompromised patient: a case report
Journal of Surgical Case Reports, 2017
Mucormycosis is a rare and highly aggressive fungal infection, with a potential to reach its fulminant phase rapidly. We report a case of a 73-year-old immunocompromised vasculopath with cutaneous mucormycosis. The disease resulted in eventual death despite aggressive surgical debridement, revascularization of his limb and amphotericin-B. This case highlights the need to recognize this disease early as a differential of a necrotic ulcer, to prevent a potentially avoidable fatality.
Cutaneous Mucormycosis of the Interscapular Region in an Immunocompetent Patient
EMJ Microbiology & Infectious Diseases, 2021
Mucormycosis is an invasive fungal infection caused by opportunistic fungi of the phylum Glomeromycotan, subphylum Mucormycotina, mainly affecting individuals with immunosuppression. Cutaneous mucormycosis is the third most common clinical form of the disease preceded by pulmonary and rhinocerebral mucormycosis. The usual factors predisposing to this infection are individuals who are immunocompromised with conditions like HIV, haematological malignancies, and diabetes mellitus, but a significant proportion of patients are immunocompetent. The agents of mucormycosis are abundantly present in nature and are transmitted to the skin by direct inoculation. It may be due to needle sticks, stings, and bites by animals, motor-vehicle accidents, natural disasters, and burn injuries. The clinical presentation is non-specific, but an indurated plaque that rapidly evolves to necrosis (eschar) is a common finding. The infection can invade locally, and also penetrate into the adjacent fat, muscle...
A Fatal Presentation of Primary Cutaneous Mucormycosis in an Immunocompetent Adult
2020
Background: Mucormycosis is an opportunistic fungal infection, affecting immunosuppressed hosts. Infection in an immunocompetent individual is uncommon, with varying degrees of severity. Usual clinical presentations include rhinocerebral and pulmonary mucormycosis, with cutaneous, gastrointestinal and disseminated forms being less common. Case Report: A 68-year-old immunocompetent adult, presented with acute onset non-traumatic large necrotizing wound over the right thigh, after receiving initial treatment at a primary center for 2 weeks. On evaluation, the patient was found to be in early sepsis, and emergency extensive debridement was done with the continuation of IV antibiotics. Fungal cultures were suggestive of Mucormycosis and treatment initiated with systemic and topical antifungal agents, despite which the patient continued to deteriorate with acute renal failure and eventually succumbed to the sepsis. Conclusion: High clinical suspicion and apt investigations are essential ...
Anais Brasileiros de Dermatologia
Cutaneous mucormycosis is an emerging fungal infection caused by opportunistic fungi of the phylum Glomeromycota. It is frequent in poorly controlled diabetic patients and individuals with immunosuppression. It is usually acquired by direct inoculation through trauma. The clinical presentation is nonspecific, but an indurated plaque that rapidly evolves to necrosis is a common finding. Diagnosis should be confirmed by demonstration of the etiological agent and new molecular diagnostic tools have recently been described. It is an invasive life-threatening disease and in order to improve survival, a prompt diagnosis and multidisciplinary management should be provided. The treatment of choice is amphotericin B, but new azoles, such as posaconazole and isavuconazole, must be considered.
Mrs. Savitha Mol G M*, Mrs. Aswathy S S, Mrs. Remya S B, Mrs. Aparna P, Dr. Silvia Navis A, Dr. Prasobh G R
Mucormycosis is the third invasive mycosis in order of importance after candidiasis and aspergillosis and is caused by fungi of the class Zygomycetes. The most important species in order of frequency is Rhizopus arrhizus (oryzae). Identification of the agents responsible for mucormycosis is based on macroscopic and microscopic morphological criteria, carbohydrate assimilation and the maximum temperature compatible with its growth. The incidence of mucormycosis is approximately 1.7 cases per1000000 inhabitants per year, and the main risk-factors for the development of mucormycosis are ketoacidosis (diabetic or other), iatrogenic immunosuppression, use of corticosteroids or deferoxamine, disruption of mucocutaneous barriers by catheters and other devices, and exposure to bandages contaminated by these fungi. The standard guidelines in management of mucormycosis involves early diagnosis, a reversing risk factors and underlying illness, surgical debridement, and immediate intravenous antifungals - usually amphotericin B. This include the prompt management of hyperglycaemia, acidosis, electrolyte imbalance and cessation of immunosuppressive drugs.
Primary Cutaneous Mucormycosis in an Immunocompetent Patient: A Case Report
Journal of Chitwan Medical College, 2021
Mucormycosis is an infrequently encountered locally invasive, aggressive fungal infection that frequently occurs in patients with an underlying immunodeficiency. It is usually diagnosed on histopathology and treated with systemic antifungals. We report a case of 16 years old female who presented with swelling on the dorsum of nose with overlying redness and tenderness. As she did not respond to antibiotics and conventional treatment, computed tomography scan and fine needle aspiration cytology were performed which revealed an inflammatory lesion. However, her histopathological examination was a surprise for all of us as it came out to be mucormycosis. She was then started on oral antifungal, and responded well. Although a rare entity, primary cutaneous mucormycosis should always be kept in mind while evaluating any swelling if it doesn't improve on conventional treatments and dealt accordingly.
Mucormycosis -A Rare Case Report
IOSR Journals , 2019
Mucormycois is a devastating opportunistic fungal infection that occurs mostly in diabetics and immunocompromised patients including those with hematologic malignancies. Neutropenia induced by bone marrow suppression in leukemic patients make them a significant risk for opportunistic fungal infection. We report a case of mucormycosis in a 17 yr old male patient, under chemotheraphy for Acute myeloid leukemia. Diagnosis was made by histopathologic examination and confirmed by special stain which revealed the characteristic appearance of the fungus.The present case highlights the importance of considering mucormycosis even in patients with mild immunosuppression.
Mucormycosis occurring in an immunocompetent patient: a case report and review of literature
Ceskoslovenska patologie, 2020
Mucormycosis is an opportunistic fungal infection with a high fatality rate and is the third most common fungal infection that is invasive in nature, next to candidiasis and aspergillosis. The condition is generally vasotropic and angio-invasive in nature. It gets disseminated to a wider area locally and also exhibits a distant spread. It is usually associated with medically compromised patients. However, mucormycosis in immunocompetent individuals is gaining attention as several cases have been reported throughout the world with a high incidence of such cases being reported from the Indian subcontinent. It is attributed to the poor socio-economic status and triggered by the local trauma due to unhygienic setup or poor health care. The pathway of pathogenesis is not clearly understood in immunocompetent patients and therefore becomes a matter of great concern. Here, we report one such case of mucormycosis affecting the maxillary region following tooth extraction in a 42-year-old male.