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Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients

Mucormycosis is an invasive, rapidly progressive, life-threatening fungal infection, with a propensity for diabetic, immunosuppressed, and trauma patients. The classic rhinocerebral variation is most common in diabetic patients. While the cutaneous form is usually caused by direct inoculation in imm...

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Detalles Bibliográficos
Autores principales: Coerdt, Kathleen M., Zolper, Elizabeth G., Starr, Amy G., Fan, Kenneth L., Attinger, Christopher E., Evans, Karen K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Plastic and Reconstructive Surgeons 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8007453/
https://www.ncbi.nlm.nih.gov/pubmed/33657778
http://dx.doi.org/10.5999/aps.2020.00549
Descripción
Sumario:Mucormycosis is an invasive, rapidly progressive, life-threatening fungal infection, with a propensity for diabetic, immunosuppressed, and trauma patients. The classic rhinocerebral variation is most common in diabetic patients. While the cutaneous form is usually caused by direct inoculation in immunocompetent patients. Cutaneous mucormycosis manifests in soft tissue and risks involvement of underlying structures. Tibial osteomyelitis can also occur secondary to cutaneous mucormycosis but is rare. Limb salvage is typically successful after lower extremity cutaneous mucormycosis even when the bone is involved. Herein, we report two cases of lower extremity cutaneous mucormycosis in diabetic patients that presented as acute worsening of chronic pretibial ulcers. Despite aggressive antifungal therapy and surgical debridement, both ultimately required amputation. Such aggressive presentation has not been reported in the absence of major penetrating trauma, recent surgery, or burns.