Cutaneous mucormycosis

Abstract

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.

The elusive nature of mucormycosis in an immunocompetent host and the role of a dermatology consult

“…Dermatology has the clinical training and diagnostic tools to aid in the rapid diagnosis and treatment of a rare presentation of immunocompetent mucormycosis. Early signs of cutaneous mucormycosis include pustules, blisters, nodules, necrotic ulcerations, ecthyma gangrenosum‐like lesions, and necrotizing cellulitis . This differs from frostbite which most commonly presents as deep red or blue/gray discoloration and necrosis on the nose and ears, not sparing the helix in the described case, a distinction that would be difficult for any clinician.…”

“…Angioinvasive mucormycosis is an opportunistic infection that typically afflicts poorly controlled diabetic and/or immunocompromised patients. The traditional means of acquisition is through either inhalation or direct inoculation in the setting of trauma . With reports of in‐hospital mortality from 30% to 50% of infected patients, early recognition and treatment of the infection is critical.…”

“…The traditional means of acquisition is through either inhalation or direct inoculation in the setting of trauma . With reports of in‐hospital mortality from 30% to 50% of infected patients, early recognition and treatment of the infection is critical. Because mucormycosis is rarely seen in an immunocompetent host, it can easily be missed, leading to delays in treatment.…”

Necrotic cheek ulcer in a liver transplant patient

“…Mucormycosis has emerged as an important opportunistic fungal infection associated with high mortality rates. Most cases are caused by the genera Rhizopus . Primary infections may be rhinocerebral, pulmonary, gastrointestinal, or cutaneous, while hematogenous spread may occur in immunocompromised hosts.…”

Mould Infections of Traumatic Wounds: A Brief Narrative Review

“…Local invasion with cutaneous, subcutaneous tissue, adipose tissue, and muscular involvement can be observed [42,47]. Necrotizing fasciitis may be secondary to cutaneous or subcutaneous mould infection [29,48,49]. Through the bloodstream, dissemination to non-contiguous sites may occur.…”