Acute Wound Closure and Reconstruction Following Head Zygomycosis: Presentation of Two Cases and Review of Literature

Adler, Neta; Seitz, Iris A.; Gottlieb, Lawrence J.

doi:10.1055/s-0028-1088233

Cited by 10 publications

(6 citation statements)

References 11 publications

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“…The most common pathogens of the Mucorales that caused bone and joint infections were Rhizopus species (15 cases) [19][20][21][22][23][24][25][26][27][28][29] followed by Apophysomyces elegans (four cases) [30][31][32][33] , Mucor species (three cases), [34][35][36] Cunninghamella bertholletiae (two cases), 37,38 and one case for each Lichtheimia (formerly Absidia) corymbifera 39 and Saksenaea vasiformis. 40 A genus was not specified in eight cases of histologically documented mucormycosis.…”

Section: Etiologymentioning

confidence: 99%

Bone and joint infections caused by mucormycetes: A challenging osteoarticular mycosis of the twenty-first century

et al. 2017

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Osteomyelitis and arthritis caused by mucormycetes are rare diseases that rank among the most challenging complications in orthopedic and trauma surgery. The aim of this work is to review the epidemiological, clinical, diagnostic, and therapeutic aspects of the osteoarticular mucormycosis with particular emphasis on high-risk patients. A systematic review of osteoarticular mucormycosis was performed using PUBMED and EMBASE databases from 1978 to 2014. Among 34 patients with median age 41 (0.5-73 years), 24 (71%) were males. While 12 (35%) were immunocompromised patients, 14 (41%) had prior surgery, and seven (21%) suffered trauma. Other underlying conditions included diabetes mellitus, hematological malignancies, transplantation, and corticosteroid therapy. The median diagnostic delay from onset of symptoms and signs was 60 (10-180) days. The principal mechanism of the infection was direct inoculation (n = 19; 56%), and in immunocompromised patients was usually hematogenous disseminated. The long bones were infected by trauma or surgery, while a wide variety of bones were involved by hematogenous dissemination. Combined surgery and amphotericin B treatment were implemented in 28 (82%) and eight (23%) had an unfavorable outcome. Osteoarticular mucormycosis occurs most frequently after trauma or surgical procedures. These infections are progressively destructive and more virulent in individuals with impaired immune systems. Early diagnosis, timely administration of amphotericin B, control of underlying conditions, and surgical debridement of infected tissue are critical for successful management of osteoarticular mucormycosis.

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Section: Etiologymentioning

confidence: 99%

Bone and joint infections caused by mucormycetes: A challenging osteoarticular mycosis of the twenty-first century

et al. 2017

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“…Only two authors (3/16) described early or immediate reconstruction. 8,9 From the cases in our literature review, multiple complications were reported secondary to delayed reconstruction. Among the 13 cases of delayed reconstruction, 9 presented postsurgical complications in which fistula was detected as the most common complication.…”

Section: Resultsmentioning

confidence: 96%

Reconstruction of Head and Neck Mucormycosis: A Literature Review and Own Experience in Immediate Reconstruction

Palacios

Hanson

Rendon

et al. 2019

J Reconstr Microsurg Open

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Background Mucormycosis is a rare invasive and fatal fungal infection. A prompt diagnosis is the most critical aspect for an improved patient outcome. Along with antifungal therapy, radical surgical debridement must be done expeditiously to eradicate this fungus. In this article, we evaluated the feasibility of immediate reconstruction after surgical debridement. Methods A retrospective study was performed at Hospital Regional de Alta Especialidad de Ixtapaluca, Estado de México, Mexico, between June 2017 and June 2018. Five patients, three males and two females, with a mean age of 39 years were presented in addition to a literature review based on MEDLINE, Google Scholar, PubMed Central, and Embase platforms until June 2018. Results From our presented series, all five flaps survived and showed no evidence of mucormycosis recurrence or flap loss. In the literature review, we collected 16 cases from 14 different publications of individuals with head and neck mucormycosis. Reconstruction was made with a free (12 cases) or pedicled flap (four cases). Eleven males and five females with a mean patient age of 33.0 years were studied. Only two authors described an early or immediate reconstruction. The average time of the delayed reconstruction after surgical debridement was 16.7 weeks. Conclusion After aggressive surgical resection, immediate reconstruction can be done safely based on clinical criteria and as long as there is no evidence of hyphae invasion on wound edges in the intraoperative pathology examination.

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“…The various complications that can occur are oronasal fistula, 21 22 naso-orbital fistula, 23 24 and oropharyngeal fistula. 25 Various other complications such as exposed meninges, 21 cerebrospinal fluid leak, 26 and even temporomandibular joint ankylosis 27 have also been reported. In our series of nine patients, none of these complications occurred.…”

Section: Discussionmentioning

confidence: 99%

Early Reconstruction with Locoregional-Free Flaps in Post-COVID-19 Rhino-orbital-cerebral Mucormycosis Craniofacial Deformities: A Single-Center Clinical Experience from India

Singh,

Haq,

Sharma

et al. 2024

Surg J (N Y)

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Aim of the Study Mucormycosis is a rare invasive and fatal fungal infection and its resurgence in coronavirus disease 2019 (COVID-19) patients has been a matter of grave concern. It is essentially a medical disease, but surgical debridement of necrotic tissues is of paramount importance leading to severe craniofacial deformities. In this case series, we present our experience with the feasibility of early reconstruction after surgical debridement. Case Series As a Dedicated COVID Center (DCH), the institute received the largest population of COVID-19 mucormycosis patients from the entire eastern region of the country between May 2021 and August 2021. More than 5,000 COVID-19 were admitted out of which 218 patients were diagnosed with mucormycosis. Nine patients, seven males and two females, with a mean age of 39 years with craniofacial mucormycosis underwent debridement and early reconstructions (2–4 weeks from first debridement and start of antifungal therapy) with free and pedicled flaps. All flaps survived and showed no evidence of recurrence. The average time of the early reconstruction after surgical debridement was 1.7 weeks once the course of systemic amphotericin B was received. Conclusion After aggressive surgical resection and a short course of antifungal therapy, early reconstruction can be done safely based on clinical criteria, as long as there is no evidence of hyphae invasion on wound edges in the intraoperative pathology examination.

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Acute Wound Closure and Reconstruction Following Head Zygomycosis: Presentation of Two Cases and Review of Literature

Cited by 10 publications

References 11 publications

Bone and joint infections caused by mucormycetes: A challenging osteoarticular mycosis of the twenty-first century

Bone and joint infections caused by mucormycetes: A challenging osteoarticular mycosis of the twenty-first century

Reconstruction of Head and Neck Mucormycosis: A Literature Review and Own Experience in Immediate Reconstruction

Early Reconstruction with Locoregional-Free Flaps in Post-COVID-19 Rhino-orbital-cerebral Mucormycosis Craniofacial Deformities: A Single-Center Clinical Experience from India

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