Abstract
Mucormycosis of the anterior abdominal wall is an uncommon disease and it is very rare to find this disease in immunocompetent, non-diabetic patients which usually affects patients with trauma, with contaminated wounds, patients with underlying malignancies or patients with immunocompromised state, e.g., diabetics. We herein report a case of primary cutaneous mucormycosis in an immunocompetent and non-diabetic patient. Our patient was a 48-year-old female, executive by profession. She was diagnosed to have cutaneous mucormycosis of the anterior abdominal wall, and was managed with multiple debridements of the wound and intravenous amphotericin B therapy. She was administered a total of 1500 mg of liposomal amphotericin B and when fully healed, split skin grafting was done. We would like to emphasize the importance of high index of suspicion and early start of therapy in a condition with high rate of mortality.
Keywords: Mucormycosis, Immunocompetent, Abdominal wall
Full Text
The Full Text of this article is available as a PDF (272.2 KB).
References
- 1.Paltauf A. Mucormycosis mucorina. Virchows Arch Pathol Anat. 1885;102:543–564. doi: 10.1007/BF01932420. [DOI] [Google Scholar]
- 2.Gilbard S.M., Rocca R.C., et al. Paranasal sinus disease and the orbit. In: Nesi F.A., et al., editors. Smith’s Ophthalmic Plastic and Reconstructive Surgery. 2nd edition. St. Louis, MO: CV Mosby; 1998. pp. 896–930. [Google Scholar]
- 3.Alan M.S. Agents of mucormycosis & related species. In: Gerald L.M., John E.B., Raphael D., editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. 6th edition. Philadelphia: Churchill Livingstone; 2005. pp. 2973–2984. [Google Scholar]
- 4.Tehmeena W., Hussain W., Zargar H. R., Sheikh A. R., Iqbal S. Primary cutaneous mucormycosis in an immunocompetent host. Mycopathologia. 2007;164:197–199. doi: 10.1007/s11046-007-9041-8. [DOI] [PubMed] [Google Scholar]
- 5.Kumar A., Khilnani G. C., Aggarwal S., Kumar S., Banerjee U., Xess I. Primary Cutaneous Mucormycosis in an Immunocompetent host. Surg Today. 2003;33:319–322. doi: 10.1007/s005950300073. [DOI] [PubMed] [Google Scholar]
- 6.Goodman N.L., Rinaldi M.G., et al. Agents of zygomycosis. In: Balows A., Hausler W.J., et al., editors. Manual of clinical microbiology. 5th edition. Washington DC: American Society for Microbiology; 1991. pp. 674–692. [Google Scholar]
- 7.Kwon-Chung KJ, Bennett JW (1992) Medical Mycology. Philadelphia Lea & Febiger
- 8.Baraia J., Munoz P., et al. Cutaneous mucormycosis in a heart transplant patient associated with a peripheral catheter. Eur J Clin Microbiol Infect Dis. 1995;14:813–815. doi: 10.1007/BF01691000. [DOI] [PubMed] [Google Scholar]
- 9.Leong K.W., Crowley B., et al. Cutaneous mucormycosis due to Absidia corymbifera occurring after bone marrow transplantation. Bone Marrow Transplant. 1997;19:513–515. doi: 10.1038/sj.bmt.1700667. [DOI] [PubMed] [Google Scholar]
- 10.Gartenberg G., Bottone E.J., et al. Hospital acquired mucormycosis (Rhizopus rhizopodiformis) of skin and subcutaneous tissue. N Engl J Med. 1978;299:1115–1118. doi: 10.1056/NEJM197811162992007. [DOI] [PubMed] [Google Scholar]
- 11.Ng T.C., Denning D.W. Liposomal Amphotericin B (AmBisome) therapy in invasive fungal infections. Arch Intern Med. 1995;155:1093–1098. doi: 10.1001/archinte.155.10.1093. [DOI] [PubMed] [Google Scholar]
- 12.Greenberg R.N., Scott L.J., Vaughn H.H., Ribes J.A. Zygomycosis (mucormycosis): Emerging clinical importance and new treatments. Curr Opin Infect Dis. 2004;17:517–525. doi: 10.1097/00001432-200412000-00003. [DOI] [PubMed] [Google Scholar]
- 13.Mileshkin L., Slavin M., Seymour J.F., Mckenzie A. Successful treatment of rhinocerebral zygomycosis using liposomal nystatin. Leuk Lymph. 2001;42:1119–1123. doi: 10.3109/10428190109097734. [DOI] [PubMed] [Google Scholar]
- 14.Spellberg B., Edwards J., Jr, Ibrahim A. Novel perspectives on mucormycosis: Pathophysiology, presentation and management. Clin Microbial Rev. 2005;18:556–569. doi: 10.1128/CMR.18.3.556-569.2005. [DOI] [PMC free article] [PubMed] [Google Scholar]