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Cutaneous mucormycosis caused by Rhizopus microsporus in an immunocompetent patient: A case report and review of literature.

ABSTRACT: Cutaneous mucormycosis is an uncommon disease and occurs rarely in immunocompetent patients.We reported the case of a 37-year-old man presenting with a skin lesion on the left side of the chest wall with no history of trauma or primary diseases. He was firstly misdiagnosed as tuberculosis and the proper treatment was thus delayed.Histopathological examination and fungal culture of the lesion confirmed cutaneous mucormycosis. The isolate was identified as Rhizopus microspores by ITS sequencing.The patient was treated with oral posaconazole 400?mg bid for 150?days.The patient recovered satisfactorily. No recurrence was found during the follow-up and no side effect of liver function was found.This case helps doctors to consider the possibility of serious fungal infection in immunocompetent patients. It also suggested that posaconazole could be an alternative choice for the treatment of mucormycosis considering the severe side effect of Amphotericin B.

SUBMITTER: Wang Y

PROVIDER: S-EPMC6024029 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Cutaneous mucormycosis caused by Rhizopus microsporus in an immunocompetent patient: A case report and review of literature.

Wang Yilun Y Zhu Min M Bao Yunqi Y Li Li L Zhu Liping L Li Feng F Xu Jinhua J Liang Jun J

Medicine 20180601 25

<h4>Rationale</h4>Cutaneous mucormycosis is an uncommon disease and occurs rarely in immunocompetent patients.<h4>Patient concerns</h4>We reported the case of a 37-year-old man presenting with a skin lesion on the left side of the chest wall with no history of trauma or primary diseases. He was firstly misdiagnosed as tuberculosis and the proper treatment was thus delayed.<h4>Diagnoses</h4>Histopathological examination and fungal culture of the lesion confirmed cutaneous mucormycosis. The isolat ...[more]

PMID: 29924015

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Project description:BackgroundGastrointestinal (GI) mucormycosis is a rare and often deadly form of mucormycosis. Delayed diagnosis can lead to an increased risk of death. Here, we report a case of GI mucormycosis following streptococcal toxic shock syndrome in a virologically suppressed HIV-infected patient.Case presentationA 25-year-old Thai woman with a well-controlled HIV infection and Grave's disease was admitted to a private hospital with a high-grade fever, vomiting, abdominal pain, and multiple episodes of mucous diarrhea for 3 days. On day 3 of that admission, the patient developed multiorgan failure and multiple hemorrhagic blebs were observed on all extremities. A diagnosis of streptococcal toxic shock was made before referral to Siriraj Hospital - Thailand's largest national tertiary referral center. On day 10 of her admission at our center, she developed feeding intolerance and bloody diarrhea due to bowel ischemia and perforation. Bowel resection was performed, and histopathologic analysis of the resected bowel revealed acute suppurative transmural necrosis and vascular invasion with numerous broad irregular branching non-septate hyphae, both of which are consistent with GI mucormycosis. Peritoneal fluid fungal culture grew a grayish cottony colony of large non-septate hyphae and spherical sporangia containing ovoidal sporangiospores. A complete ITS1-5.8S-ITS2 region DNA sequence analysis revealed 100% homology with Rhizopus microsporus strains in GenBank (GenBank accession numbers KU729104 and AY803934). As a result, she was treated with liposomal amphotericin B. However and in spite of receiving appropriate treatment, our patient developed recurrent massive upper GI bleeding from Dieulafoy's lesion and succumbed to her disease on day 33 of her admission.ConclusionDiagnosis of gastrointestinal mucormycosis can be delayed due to a lack of well-established predisposing factors and non-specific presenting symptoms. Further studies in risk factors for abdominal mucormycosis are needed.

Dataset Information

Cutaneous mucormycosis caused by Rhizopus microsporus in an immunocompetent patient: A case report and review of literature.

Publications

Cutaneous mucormycosis caused by Rhizopus microsporus in an immunocompetent patient: A case report and review of literature.

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