Multiple Skin Abscesses Caused by <i>Rhizopus</i> sp. Infection after <i>Candida albicans</i> Infection in an Immunocompromised Patient

Abstract

A 66-year-old woman with diabetes who was treated with prednisolone (15 mg/day) for autoimmune hepatitis developed multiple erythematous nodules with retention of purulent fluid on her lower right limb. Candida albicans was cultured from the nodules. She was started on oral fluconazole, and the lesions subsided. However, multiple dark-red abscesses and indurations newly appeared on the left crus. Histopathological examination showed numerous branched hyphae, and tissue culture yielded a Rhizopus microsporus-related fungus. She was treated with liposomal amphotericin B combined with drainage and debridement. However, she died because of poor control of the infection and hepatic disorder.

Case reports of invasive mucormycosis associated neutropenic enterocolitis in leukemic children: diagnostic and treatment challenges and review of literature

“…Host factors related to mucormycosis associated with neutropenic enterocolitis are malignancy type [ 19 – 21 ], disease station (relapse) [ 19 , 21 ], prolonged neutropenia [ 12 , 22 ], history of typhlitis, the intensity of chemotherapy-associated immunosuppression (including chemotherapy and corticosteroids) [ 12 , 15 , 23 ], unsolicited drug side effects (voriconazole and L-AmB prophylaxis) [ 23 – 25 ], coinfections [ 19 , 26 ], trauma (including surgical interventions), tissue ischemia [ 15 , 20 ], and contaminated food ingestion [ 21 , 27 ]. Our patients have a history of fresh carrot juice consumption during the neutropenic phase.…”

Mycoproteins and their health‐promoting properties: Fusarium species and beyond

“…This study highlights the potential for infec-tions caused by A. flavus and the R. oryzae complex to manifest in patients with diabetes mellitus, particularly in association with a hyperglycemic crisis. Notably, other studies have also reported Rhizopus species infections in individuals with diabetes (Engle et al, 2021;Makino et al, 2019).…”

Fungal infections in liver cirrhosis

“…Lewitt et al report a case of a 36-year-old female patient with chronic hepatitis C who developed an intracranial abscess due to Rhizopus despite not having any other immunocompromising factors ( 66 ). Makino et al reported a 66-year-old female patient with autoimmune hepatitis who developed skin abscesses due to Rhizopus and ultimately died from her infection despite antifungal therapy ( 67 ). McBride et al had also previously reported a young immunocompetent male patient with hepatic dysfunction of likely toxic etiology who developed disseminated Rhizopus infection of the respiratory and gastrointestinal tracts ( 68 ).…”