[Cutaneous mucormycosis caused by Rhizopus microsporus]

Ann Dermatol Venereol. 2014 Mar;141(3):201-5. doi: 10.1016/j.annder.2013.10.044. Epub 2013 Dec 11.
[Article in French]

Abstract

Background: Mucormycosis are rare fungal infections occurring chiefly in the lung or the rhinocerebral compartment, particularly in patients with immunodeficiency or mellitus diabetes. We report the case of an elderly patient with cutaneous mucormycosis caused by Rhizopus microsporus.

Patients and methods: An 89-year-old man presented a skin lesion of the forearm rapidly becoming inflammatory and necrotic. The patient had been treated for 2months with oral corticosteroids for idiopathic thrombocytopenia. Histological and mycological examination of the skin biopsy revealed the presence of a filamentous fungus, R. microsporus. The outcome was unfavorable, despite prescription of high-dose liposomal amphotericin B.

Discussion: Mucormycosis are infrequent opportunistic infections caused by angio-invasive fungi belonging to the Mucorales order. Cutaneous presentations are rare, and in rare cases the species R. microsporus is isolated in clinical samples. Diagnosis is based on histological examination highlighting the characteristic mycelium within infected tissue, together with ex vivo mycological identification using morphological and molecular methods. Treatment consists of liposomal amphotericin B combined with debridement surgery.

Conclusion: R. microsporus is a marginal fungal species rarely isolated in clinical practice, and even less in dermatology departments. This clinical case report highlights the severity of infection with this fungus, particularly in the absence of early surgery.

Keywords: Amphotéricine B liposomale; Chirurgie; Corticosteroids; Corticoïdes; Cutaneous mucormycosis; Debridement surgery; Liposomal amphotericin B; Mucormycose cutanée; Rhizopus microsporus.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Aged, 80 and over
  • Amphotericin B / administration & dosage
  • Biopsy
  • Dermatomycoses / diagnosis*
  • Dermatomycoses / drug therapy
  • Dermatomycoses / microbiology*
  • Dermatomycoses / pathology
  • Dose-Response Relationship, Drug
  • Humans
  • Male
  • Mucormycosis / diagnosis*
  • Mucormycosis / drug therapy
  • Mucormycosis / microbiology*
  • Mucormycosis / pathology
  • Necrosis
  • Opportunistic Infections / diagnosis*
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / microbiology*
  • Opportunistic Infections / pathology
  • Palliative Care
  • Rhizopus* / ultrastructure
  • Skin / pathology
  • Thrombocytopenia / drug therapy

Substances

  • Adrenal Cortex Hormones
  • liposomal amphotericin B
  • Amphotericin B