Arch Plast Surg.
2021 Mar;48(2):231-236. 10.5999/aps.2020.00549.
Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients
- Affiliations
-
- 1Georgetown University School of Medicine, Washington, D.C. USA
- 2Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USA
- 3Department of Pathology, MedStar Georgetown University Hospital, Washington, D.C., USA
- KMID: 2514042
- DOI: http://doi.org/10.5999/aps.2020.00549
Abstract
- 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.
