Cutaneous mucormycosis caused by Rhizopus microsporus in an immunocompetent patient

Abstract

Rationale:Cutaneous mucormycosis is an uncommon disease and occurs rarely in immunocompetent patients.Patient concerns:We reported the case of a 37-year-old man presenting with a skin lesion on the left side of the chest wall with no history of trauma or primary diseases. He was firstly misdiagnosed as tuberculosis and the proper treatment was thus delayed.Diagnoses:Histopathological examination and fungal culture of the lesion confirmed cutaneous mucormycosis. The isolate was identified as Rhizopus microspores by ITS sequencing.Interventions:The patient was treated with oral posaconazole 400 mg bid for 150 days.Outcomes:The patient recovered satisfactorily. No recurrence was found during the follow-up and no side effect of liver function was found.Lessons:This case helps doctors to consider the possibility of serious fungal infection in immunocompetent patients. It also suggested that posaconazole could be an alternative choice for the treatment of mucormycosis considering the severe side effect of Amphotericin B.

Mucocutaneous manifestations of COVID-19-associated mucormycosis: A retrospective cross-sectional study

“…Histopathological evaluation with periodic acid-Schiff and haematoxylin and eosin stain showed broad aseptate hyphae folded in a ribbon-like manner and branched at 90 o angle to each other in one primary cutaneous found was a scaly blackish plaque on the right side of the forehead with few superficial pustules over the surface, which is an infrequently described clinical presentation for the same. 11,12 For confirmation of primary cutaneous mucormycosis, histopathology has a higher yield than microbiology, corroborating with our case. 5 CEMRI findings like mild enhancing cutaneous and subcutaneous tissue were similar to changes described in few case reports.…”

“…Suppuration in cutaneous mucormycosis has been described earlier, but clinically frank abscess has hitherto been considered a rare manifestation, which was contrary to our observation. 12,18,19 The possibility of a secondary bacterial infection or combined infection with actinomycosis, reported in the literature as a cause for this suppuration was ruled out in all patients in the cutaneous abscess group by negative microbiological results from pus specimens for both these organisms. 20,21 Mucorales as the cause of abscess were further supported by the presence of characteristic fungal hyphae in pus on potassium hydroxide mounts (n = 8) and positive growth on fungal culture (n = 4).…”

Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium

“…[26][27][28][29][30][31] Abscesses, skin swelling, necrosis, dry ulcers, and eschars are characteristic presentations (figure 1A and G). [32][33][34] For further information on cutaneous and soft-tissue mucormycosis, see appendix p 6.…”

Mucormycosis: risk factors, diagnosis, treatments, and challenges during COVID-19 pandemic

“…Mucorales infections can be contracted by inhalation of spores, absorption of infected meals, or inoculation of damaged surfaces or injuries (Lelievre et al 2014 ). Mucormycosis is most common in highly immunocompromised hosts in developing countries (Nasa et al 2017 ; Wang et al 2018 ). In developed economies, mucormycosis is commonly seen in patients with a bad prognosis regulated diabetes mellitus (DM).…”