Cutaneous mucormycosis secondary to penetrative trauma

Abstract

An aggressive and early surgical approach, even at the expense of disfigurement, is necessary to reduce mortality in the setting of cutaneous mucormycosis that results from penetrating trauma [4,8,9]. Anti-fungal therapy and negative pressure wound therapy are formidable adjuncts.

Invasive Fungal Infections Secondary to Traumatic Injury

“…At the species level, commonly identified organisms include Rhizopus oryzae, Lichtheimia corymbifera, Apophysomyces elegans, Apophysomyces trapeziformis, Mucor racemosus, and Saksenaea vasiformis (Neblett Fanfair et al, 2012;Lelievre et al, 2014;Millon et al, 2016;Arnaiz-Garcia et al, 2009;Chander et al, 2010;Li et al, 2013). Although Rhizopus oryzae accounts for 70% of all mucormycosis infections, post-traumatic IFI in general appears to be caused by a more heterogeneous collection of Mucorales organisms (Kaushik, 2012;Lelievre et al, 2014;Bilal et al, 2016). Aspergillus (esp.…”

“…Invasive fungal infections (IFI) are a rare but serious complication of traumatic injury characterized by fungal angioinvasion and resultant vessel thrombosis and tissue necrosis (Alonso et al, 2006;Spellberg et al, 2005). In contrast to other settings, posttraumatic IFI occurs through direct inoculation of tissue with spores at the site of injury (Bilal et al, 2016). Fungi may then take advantage of an acidemic, iron-rich environment to proliferate and invade vessels through hyphae growth.…”

Invasive fungal disease in humans: are we aware of the real impact?

“…Motor vehicle collisions and blasts from war-related injuries are also common forms to get severe trauma among the population. (71) After dissemination occurs, even young, previously healthy patients are susceptible to mucormycosis and even with aggressive approaches such as disfiguring debridement or amputation, case-fatality rate can reach 100%. (71,72) In conclusion, concomitant with the increased prevalence of at-risk and immunocompromised people, rates and spectrum of invasive fungal infections are rising and becoming more frequent worldwide.…”

Mould Infections of Traumatic Wounds: A Brief Narrative Review

“…The clinical presentation of post-traumatic mould infections represents a challenge for physicians, ranging from minimal oedema associated with erythematous skin to necrotizing lesions with concomitant septic shock [4,6,8]. Absence of response to antibacterial therapy (or partial response in view of the nonnegligible prevalence of mixed bacterial-fungal infections) may help recognizing the possibility of mould infection, although, at least in at-risk categories of patients with severe traumatic injuries (e.g., soldiers, natural disasters), mould infections should already be suspected before waiting for response to antibacterials, owing to the possible rapid progression to necrosis and septic shock [8,50,51].…”

“…Mould infections may also follow traumatic injuries, with direct fungal inoculum in the site of injury and subsequent angioinvasion, possibly resulting in vessel thrombosis and tissue necrosis [4,5]. In this regard, penetrating traumas are a well-known risk factor for mucormycosis, especially amongst soldiers during campaigns war, although mould infections may also be observed in civilians experiencing severe trauma [6][7][8].…”