A Fatal Presentation of Primary Cutaneous Mucormycosis in an Immunocompetent Adult
Poojitha Yalla *
Department of Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, India.
Saumya Bhagat
Department of Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, India.
L. Badareesh
Department of Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, India.
Mary Mathew
Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Mucormycosis is an opportunistic fungal infection, affecting immunosuppressed hosts. Infection in an immunocompetent individual is uncommon, with varying degrees of severity. Usual clinical presentations include rhinocerebral and pulmonary mucormycosis, with cutaneous, gastrointestinal and disseminated forms being less common.
Case Report: A 68-year-old immunocompetent adult, presented with acute onset non-traumatic large necrotizing wound over the right thigh, after receiving initial treatment at a primary center for 2 weeks. On evaluation, the patient was found to be in early sepsis, and emergency extensive debridement was done with the continuation of IV antibiotics. Fungal cultures were suggestive of Mucormycosis and treatment initiated with systemic and topical antifungal agents, despite which the patient continued to deteriorate with acute renal failure and eventually succumbed to the sepsis. Conclusion: High clinical suspicion and apt investigations are essential to initiate the appropriate antifungal therapy and to prevent life-threatening invasive infection.
Keywords: Cutaneous mucormycosis, immunocompetent, soft tissue infections, renal disease.