Pyoderma gangraenosum caused by Rhizopus arrhizus

Abstract

A rare case of pyoderma gangraenosum caused by Rhizopus arrhizus is reported. The patient, a 50-year-old male farmer, was admitted to hospital complaining of gangrening and festering of the right upper arm with severe pain for nearly 2 months. A lesion was found on the inside of right upper arm. The central skin part of the lesion became black dry gangrenous, the periphery was deeply ulcerated with yellow-green pus. The necrotic crust, biceps, triceps and vessels inherited a histopathologically proven fungal infection. The fungus isolated was identified as Rhizopus arrhizus. The infection was successfully treated with itraconazole.

Diagnosis and treatment of mucormycosis in patients with hematological malignancies: guidelines from the 3rd European Conference on Infections in Leukemia (ECIL 3)

“…20,81 In an experimental model, itraconazole reduced mortality of immunocompetent mice infected with Lichtheimia corymbifera and Apophysomyces elegans but not in animals infected with Rhizopus microspores. 82 Despite rare case reports, [83][84][85][86] data are insufficient to support its use as monotherapy for mucormycosis in clinical practice.…”

Chronic Recurrent Multifocal Osteomyelitis Preceding Pyoderma Gangrenosum and Occult Ulcerative Colitis in a Pediatric Patient

“…Given the inconsistent immunologic findings, the possibility that a slow-growing, fastidious bacterium, virus, or fungus may be the causative agent in CRMO and PG has been considered (35,36). However, most efforts have failed to isolate any microbes from the affected areas (37). Positive cultures for low virulence pathogens, especially Mycobacterium bovis and Helicobacter pylori, have been sporadically reported in IBD.…”

Pyoderma gangrenosum of the eyelid and acute rhinosinusitis

“…Infection has occasionally been associated with PG, including Group A haemolytic streptococcal infection of the hand, 13 deep fungal infection of the upper arm with Rhizopus arrhizus, 14 HIV infection 15 and chronic recurrent osteomyelitis. Infection has occasionally been associated with PG, including Group A haemolytic streptococcal infection of the hand, 13 deep fungal infection of the upper arm with Rhizopus arrhizus, 14 HIV infection 15 and chronic recurrent osteomyelitis.…”

“…PG is associated with systemic disease including disorders of the gut, liver, joints and blood, however, in 10±30% of patients no cause is found. Infection has occasionally been associated with PG, including Group A haemolytic streptococcal infection of the hand, 13 deep fungal infection of the upper arm with Rhizopus arrhizus, 14 HIV infection 15 and chronic recurrent osteomyelitis. 16 We feel that that inflammatory bowel disease was the associated underlying pathology in our case and the rhinosinusitis was likely to have been coincidental, as the patient had suffered previous episodes of both conditions independently.…”