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Case Repository| Volume 45, ISSUE 12, P1189.e1-1189.e5, December 2020

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Topical Treatment for Cutaneous Mucormycosis of the Upper Extremity

Published:March 23, 2020DOI:https://doi.org/10.1016/j.jhsa.2020.01.015
      Mucormycosis is a relatively rare but extremely aggressive fungal infection that commonly affects patients who are compromised hosts. These infections typically come in various patterns: pulmonary, sinus, rhinocerebral, cerebral, cutaneous, or disseminated forms. Treatment usually consists of a combination of antifungal agents and surgical debridement, although morbidity and mortality are high. In this case report, we describe the course of a patient with a disseminated Mucor infection, primarily involving the upper extremities, who was successfully treated with topical and systemic antifungal agents without the need for surgical intervention.

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      References

        • Eucker J.
        • Sezar O.
        • Graf B.
        • Possinger K.
        Mucormycoses.
        Mycoses. 2001; 44: 253-260
        • Roden M.M.
        • Zaoutis T.E.
        • Buchanan W.L.
        • et al.
        Epidemiology and outcome of zygomycosis: a review of 929 reported cases.
        Clin Infect Dis. 2005; 41: 634-653
        • Katragkou T.
        • Walsh J.
        • Roilides E.
        Why is mucormycosis more difficult to cure than more common mycoses?.
        Clin Microbiol Infect. 2014; 20: 74-81
        • Moran S.L.
        • Strickland J.
        • Shin A.Y.
        Upper-extremity mucormycosis infections in immunocompetent patients.
        J Hand Surg Am. 2006; 31: 1201-1205
        • Linberry K.D.
        • Boettcher A.K.
        • Blount A.L.
        • et al.
        Cutaneous mucormycosis of the upper extremity in an immunocompetent host: case report.
        J Hand Surg Am. 2012; 37: 787-791
        • Cornely O.A.
        • Arikan-Akdagli S.
        • Dannaoui E.
        • et al.
        ESCMID and ECMM Joint Clinical Guidelines for the Diagnosis and Management of Mucormycosis 2013.
        Clin Microbiol Infect. 2014; 20: 5-26
        • Fathi P.
        • Vranis N.M.
        • Paryavi E.
        Diagnosis and treatment of upper extremity mucormycosis infections.
        J Hand Surg Am. 2015; 40: 1032-1034
        • Jeong W.
        • Keighley C.
        • Wolfe R.
        • et al.
        The contemporary management and clinical outcomes of mucormycosis: a systematic review and meta-analysis of case reports.
        Int J Antimicrob Agents. 2019; 53: 589-597
        • Saraiya H.A.
        Successful management of cutaneous mucormycosis by delaying debridement.
        Ann Plast Surg. 2012; 69: 301-306
        • Ayaz M.
        • Moein R.
        Myocutaneous mucormycosis in a diabetic burnt patient led to upper extremity amputation: a case report.
        Bull Emerg Trauma. 2017; 5: 58-62
        • Iida T.
        • Sawada N.
        • Takahashi M.
        • et al.
        Successful treatment of invasive mucormycosis in a liver transplant patient by arm amputation.
        Transplant Proc. 2010; 42: 2794-2796
        • Chew H.H.
        • Abuzeid A.
        • Singh D.
        • Tai C.C.
        Surgical wound mucormycosis necessitating hand amputation: a case report.
        J Orthop Surg (Hong Kong). 2008; 16: 267-269
        • Kelpin J.
        • Fahrenkopf M.
        • Kelley J.
        • et al.
        Mucormycosis osteomyelitis of the hand.
        J Hand Surg Am. 2019; 44: 424.e1-424.e4
        • Raizman N.M.
        • Parisien M.
        • Grafe M.W.
        • Gordon R.J.
        • Rosenwasser M.P.
        Mucormycosis of the upper extremity in a patient with alcoholic encephalopathy.
        J Hand Surg Am. 2007; 32: 384-388
        • Di Pentima M.C.
        • Chan S.
        • Powell J.
        • Napoli J.A.
        • Walter A.W.
        • Walsh T.J.
        Topical amphotericin B in combination with standard therapy for severe necrotizing skin and soft-tissue mucormycosis in an infant with bilineal leukemia: case report and review.
        J Pediatr Hematol Oncol. 2014; 36: e468-e470
        • Frankenburg S.
        • Glick D.
        • Klaus S.
        • Barenholz Y.
        Efficacious topical treatment for murine cutaneous leishmaniasis with ethanolic formulations of amphotericin B.
        Antimicrob Agents Chemother. 1998; 42: 3092-3096