Primary Cutaneous Mucormycosis in a Patient with Burn Wounds Due to Lichtheimia ramosa

Kaur, Ravinder; Bala, Kiran; Ahuja, Rajeev; Srivastav, Prabhat; Bansal, Umesh

doi:10.1007/s11046-014-9805-x

Cited by 22 publications

(28 citation statements)

References 32 publications

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“…Tuberculid and suppurative granulomatous patterns have also been reported. Unlike SCM cases, hyphae are scarce in PCM cases, particularly on immunocompetent [14,21,65,74].…”

Section: Diagnosismentioning

confidence: 95%

“…Rhizopus arrhizus (formerly Rhizopus oryzae) is the main etiological agent for mucormycosis, contributing with 47 to 85 %; however, CM cases are frequently due to: Apophysomyces elegans (complex) [12,13,16,17], Apophysomyces trapeziformis [16, 18, 19•], Lichtheimia corymbifera [14,16,20], Lichtheimia ramosa [16,21], Saksenaea vasiformis [12,13,16,17,22], Mucor irregularis (formerly Rhizomucor variablilis) [16,[23][24][25][26], Rhizopus arrhizus [3, 4, 9•, 12, 15, 16], and Mucor sp. [9•, 12, 15, 16].…”

Section: Introductionmentioning

confidence: 99%

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Cutaneous Mucormycosis: Mycological, Clinical, and Therapeutic Aspects

Bonifáz

Tirado‐Sánchez

Calderón

et al. 2015

Curr Fungal Infect Rep

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Cutaneous mucormycosis (CM) is caused by ubiquitous filamentous fungi belonging to the order Mucorales. It is a rare, emerging mycosis, with increasing incidence since the last two decades, only surpassed by rhinocerebral and pulmonary mucormycosis. CM can be further classified in primary and secondary clinical forms. Primary cases can be seen on immunocompetent patients, frequently due to traumatic injuries, while in immunocompromised patients (those with diabetes mellitus or hematologic malignancies), lesions can arise at catheter insertion sites or after the use of contaminated adhesive tapes. Clinical features of primary cutaneous mucormycosis (PCM) are necrosis, followed by ulceration, generally associated to good prognosis. Secondary cutaneous mucormycosis (SCM) is related to rhinocerebral and/or disseminated forms. SCM usually starts as a palpebral fistula, as an erythematous area that rapidly evolves to necrosis and ulceration, related to worse prognosis. Direct examination, cultures, skin biopsies, and molecular tests are performed to diagnose both clinical forms. Liposomal amphotericin B (LAmB) in combination with surgical debridement constitutes the treatment of choice; however, for SCM, the addition of posaconazole or caspofungin is recommended.

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“…Tuberculid and suppurative granulomatous patterns have also been reported. Unlike SCM cases, hyphae are scarce in PCM cases, particularly on immunocompetent [14,21,65,74].…”

Section: Diagnosismentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Cutaneous Mucormycosis: Mycological, Clinical, and Therapeutic Aspects

Bonifáz

Tirado‐Sánchez

Calderón

et al. 2015

Curr Fungal Infect Rep

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“…The combination of loss of cutaneous barrier and exposure to broad-spectrum antibiotics targeting bacterial infection puts these patients at particular risk of invasive fungal infections. Among the fungal etiologies, Candida remains the most common overall, but members of the Mucorales order are becoming more frequent [1,2]. Formerly classified in the taxonomi-cally vague "zygomycetes" group, the Mucorales are environmental fungi that can be opportunistic pathogens in patients with impaired host defenses, including patients with diabetes, as was the case for our patient.…”

Section: Fungal Infections In Severe Burn Patientsmentioning

confidence: 73%

Widespread Lichtheimia Infection in a Patient with Extensive Burns: Opportunities for Novel Antifungal Agents

et al. 2018

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The Mucorales fungi-formerly classified as the zygomycetes-are environmentally ubiquitous fungi, but generally rare causes of clinical infections. In the immunocompromised host, however, they can cause invasive, rapidly spreading infections that confer a high risk of morbidity and mortality, often despite surgical and antifungal therapy. Patients with extensive burn injuries are particularly susceptible to skin and soft-tissue infections with these organisms. Here, we present a case of Lichtheimia infection in a patient with extensive full-thickness burns that required significant and repeated surgical debridement successfully treated with isavuconazole and adjunctive topical amphotericin B washes. We also review the available literature on contemporary antifungal treatment for Lichtheimia species and related Mucorales fungi.

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“…Three nosocomial outbreaks were reported: one in Belgium in 2005 and two in France in 2018 [13,14,15,16]. Lastly, 25 reports of individual cases were identified between 1990 and 2019, including publications from the USA ( n = 12, with three cases occurring in the Middle East (Afghanistan, Iraq) and one in Japan) [17,18,19,20,21,22,23,24,25,26,27,28], from Asia ( n = 6; two in China, three in India, one in Iran) [29,30,31,32,33,34], from Europe ( n = 3; in Czech Republic, Germany, and the U.K.) [35,36,37], from Australia ( n = 3) [3,38,39], and from Ecuador ( n = 1) [40]. The data from case series and outbreaks are summarized in Table 1.…”

Section: Results Of Pubmed Searchmentioning

confidence: 99%

Mucormycosis in Burn Patients

Devauchelle

Jeanne

Fréalle

2019

JoF

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Patients with extensive burns are an important group at risk for cutaneous mucormycosis. This study aimed to perform a systematic review of all reported mucormycosis cases in burn patients from 1990 onward. A Medline search yielded identification of 7 case series, 3 outbreaks, and 25 individual cases reports. The prevalence reached 0.04%–0.6%. The median age was 42–48 in the case series and outbreaks, except for the studies from military centers (23.5–32.5) and in individual reports (29.5). The median total body surface area reached 42.5%–65%. Various skin lesions were described, none being pathognomonic: the diagnosis was mainly reached because of extensive necrotic lesions sometimes associated with sepsis. Most patients were treated with systemic amphotericin B or liposomal amphotericin B, and all underwent debridement and/or amputation. Mortality reached 33%–100% in the case series, 29%–62% during outbreaks, and 40% in individual cases. Most patients were diagnosed using histopathology and/or culture. Mucorales qPCR showed detection of circulating DNA 2–24 days before the standard diagnosis. Species included the main clinically relevant mucorales (i.e., Mucor, Rhizopus, Absidia/Lichtheimia, Rhizomucor) but also more uncommon mucorales such as Saksenaea or Apophysomyces. Contact with soil was reported in most individual cases. Bandages were identified as the source of contamination in two nosocomial outbreaks.

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Primary Cutaneous Mucormycosis in a Patient with Burn Wounds Due to Lichtheimia ramosa

Cited by 22 publications

References 32 publications

Cutaneous Mucormycosis: Mycological, Clinical, and Therapeutic Aspects

Cutaneous Mucormycosis: Mycological, Clinical, and Therapeutic Aspects

Widespread Lichtheimia Infection in a Patient with Extensive Burns: Opportunities for Novel Antifungal Agents

Mucormycosis in Burn Patients

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