Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients
Mucormycosis is an invasive, rapidly progressive, life-threatening fungal infection, with a propensity for diabetic, immunosuppressed, and trauma patients. The classic rhinocerebral variation is most common in diabetic patients. While the cutaneous form is usually caused by direct inoculation in imm...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2021-03-01
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| Series: | Archives of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2020.00549 |
| _version_ | 1828355350426812416 |
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| author | Kathleen M. Coerdt Elizabeth G. Zolper Amy G. Starr Kenneth L. Fan Christopher E. Attinger Karen K. Evans |
| author_facet | Kathleen M. Coerdt Elizabeth G. Zolper Amy G. Starr Kenneth L. Fan Christopher E. Attinger Karen K. Evans |
| author_sort | Kathleen M. Coerdt |
| collection | DOAJ |
| description | Mucormycosis is an invasive, rapidly progressive, life-threatening fungal infection, with a propensity for diabetic, immunosuppressed, and trauma patients. The classic rhinocerebral variation is most common in diabetic patients. While the cutaneous form is usually caused by direct inoculation in immunocompetent patients. Cutaneous mucormycosis manifests in soft tissue and risks involvement of underlying structures. Tibial osteomyelitis can also occur secondary to cutaneous mucormycosis but is rare. Limb salvage is typically successful after lower extremity cutaneous mucormycosis even when the bone is involved. Herein, we report two cases of lower extremity cutaneous mucormycosis in diabetic patients that presented as acute worsening of chronic pretibial ulcers. Despite aggressive antifungal therapy and surgical debridement, both ultimately required amputation. Such aggressive presentation has not been reported in the absence of major penetrating trauma, recent surgery, or burns. |
| first_indexed | 2024-04-14T02:40:55Z |
| format | Article |
| id | doaj.art-196412eab1fb4a52a6f7d877b3bc4b27 |
| institution | Directory Open Access Journal |
| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-04-14T02:40:55Z |
| publishDate | 2021-03-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj.art-196412eab1fb4a52a6f7d877b3bc4b272022-12-22T02:17:07ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712021-03-01480223123610.5999/aps.2020.005493830Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patientsKathleen M. Coerdt0Elizabeth G. Zolper1Amy G. Starr2Kenneth L. Fan3Christopher E. Attinger4Karen K. Evans5Georgetown University School of Medicine, Washington, D.C. USADepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USADepartment of Pathology, MedStar Georgetown University Hospital, Washington, D.C., USADepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USADepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USADepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USAMucormycosis is an invasive, rapidly progressive, life-threatening fungal infection, with a propensity for diabetic, immunosuppressed, and trauma patients. The classic rhinocerebral variation is most common in diabetic patients. While the cutaneous form is usually caused by direct inoculation in immunocompetent patients. Cutaneous mucormycosis manifests in soft tissue and risks involvement of underlying structures. Tibial osteomyelitis can also occur secondary to cutaneous mucormycosis but is rare. Limb salvage is typically successful after lower extremity cutaneous mucormycosis even when the bone is involved. Herein, we report two cases of lower extremity cutaneous mucormycosis in diabetic patients that presented as acute worsening of chronic pretibial ulcers. Despite aggressive antifungal therapy and surgical debridement, both ultimately required amputation. Such aggressive presentation has not been reported in the absence of major penetrating trauma, recent surgery, or burns.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2020.00549mucormycosisleg ulceramputationdiabetes mellituswound infection |
| spellingShingle | Kathleen M. Coerdt Elizabeth G. Zolper Amy G. Starr Kenneth L. Fan Christopher E. Attinger Karen K. Evans Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients Archives of Plastic Surgery mucormycosis leg ulcer amputation diabetes mellitus wound infection |
| title | Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients |
| title_full | Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients |
| title_fullStr | Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients |
| title_full_unstemmed | Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients |
| title_short | Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients |
| title_sort | cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients |
| topic | mucormycosis leg ulcer amputation diabetes mellitus wound infection |
| url | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2020.00549 |
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