A case report of cutaneous mucormycosis of the hand after minor trauma in a patient with acute myeloid leukaemia.
Cutaneous mucormycosis
Fungal infection
Immunosuppression
Leukaemia
Mucorales
Journal
Trauma case reports
ISSN: 2352-6440
Titre abrégé: Trauma Case Rep
Pays: Netherlands
ID NLM: 101711730
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
accepted:
06
07
2019
entrez:
31
7
2019
pubmed:
31
7
2019
medline:
31
7
2019
Statut:
epublish
Résumé
Mucormycosis is a rare but life-threatening infection, caused by fungi of the Mucorales order, which can be found in soil, rotting leaves or on animals. Through characteristic angioinvasive growth, infections with mucor spores can occur as a pulmonary, rhinocerebral or cutaneous form. Infections mainly affect immunosuppressed patients with a history of uncontrolled diabetes or haematological malignancies, among others. Treatment is multimodal and requires an immediate combination of intravenous amphotericin B therapy and serial surgical debridements. Only a limited number of cases of cutaneous mucormycosis of the hand have been documented and described previously. We report a cutaneous mucormycosis in an elderly patient with a therapy-resistant acute myeloid leukaemia after a minor trauma on his right hand, sustained whilst gardening. The fungal infection was treated with serial radical debridements, vacuum-assisted negative-pressure wound closure technique and intravenous antifungals. Despite successful eradication of the fungal infection, a palliative open wound care concept was implemented during the terminal course of the patient's leukaemia. Cutaneous mucormycosis is a rare but fulminant fungal infection mostly affecting immunosuppressed patients. Survival is possible when diagnosed and treated early, yet mortality rates remain high.
Sections du résumé
BACKGROUND
BACKGROUND
Mucormycosis is a rare but life-threatening infection, caused by fungi of the Mucorales order, which can be found in soil, rotting leaves or on animals. Through characteristic angioinvasive growth, infections with mucor spores can occur as a pulmonary, rhinocerebral or cutaneous form. Infections mainly affect immunosuppressed patients with a history of uncontrolled diabetes or haematological malignancies, among others. Treatment is multimodal and requires an immediate combination of intravenous amphotericin B therapy and serial surgical debridements. Only a limited number of cases of cutaneous mucormycosis of the hand have been documented and described previously.
CASE PRESENTATION
METHODS
We report a cutaneous mucormycosis in an elderly patient with a therapy-resistant acute myeloid leukaemia after a minor trauma on his right hand, sustained whilst gardening. The fungal infection was treated with serial radical debridements, vacuum-assisted negative-pressure wound closure technique and intravenous antifungals. Despite successful eradication of the fungal infection, a palliative open wound care concept was implemented during the terminal course of the patient's leukaemia.
CONCLUSIONS
CONCLUSIONS
Cutaneous mucormycosis is a rare but fulminant fungal infection mostly affecting immunosuppressed patients. Survival is possible when diagnosed and treated early, yet mortality rates remain high.
Identifiants
pubmed: 31360744
doi: 10.1016/j.tcr.2019.100221
pii: S2352-6440(19)30055-X
pii: 100221
pmc: PMC6637271
doi:
Types de publication
Case Reports
Langues
eng
Pagination
100221Déclaration de conflit d'intérêts
None of the authors (TM, KS, AT, SM) state any conflicts of interest.
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