Journal
ARCHIVES OF PLASTIC SURGERY-APS
Volume 48, Issue 2, Pages 231-236Publisher
KOREAN SOC PLASTIC & RECONSTRUCTIVE SURGERY
DOI: 10.5999/aps.2020.00549
Keywords
Mucormycosis; Leg ulcer; Amputation; Diabetes mellitus; Wound infection
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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. Cutaneous mucormycosis manifests in soft tissue and risks involvement of underlying structures. Despite aggressive antifungal therapy and surgical debridement, amputation may still be required in some cases.
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.
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