Mucormycosis is a rare disease caused by fungi. Most commonly involved sites of mucormycosis infection are sinuses, lungs, skin and soft tissues. Systemic risk factors for mucormycosis are diabetes mellitus, neutropenia, corticosteroid use, hematological malignancies, organ transplantation, metabolic acidosis, deferoxamine use and advanced age. Local risk factors are history of trauma, burns, surgery and motor vehicle accidents. We present a case of cutaneous mucormycosis in a patient with diabetes mellitus. A 66-year-old female with uncontrolled diabetes mellitus, admitted with necrotizing lesion after minor abrasions on leg. We took a culture of the lesion and it is diagnosed with mucormycosis. Disease progressed despite administration of systemic amphotericin B. We performed above-knee amputation and changed antifungal agents into liposomal amphotericin B. A tissue biopsy showed nonseptate, irregularly wide fungal hyphae with frequent right-angle branching. Our case report suggests that patients with risk factors should be observed carefully.
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Rhinocerebral mucormycosis is a well-described fulminant fungal infection that typically presents in a rapidly fulminant manner. This condition is more likely to occur among patient with diabetes mellitus, malignant tumors, who have long-term steroid treatment, or who suffer from some debilitating diseases.
We report 3 cases of rhinoorbitocerebral mucormycosis, all suffered from diabetes mellitus. In all 3 cases, endoscopic sinus surgery was done and the antifungal agent(amphotericin B) was administered intravenously, and two patients died. One survivor who had focal extension of paranasal sinus and orbit, required one surgical intervention without orbital exenteration and he is alive without recurrence disease.
The severity of the disease is probably dependent upon the gost resistance to the invasion of phycomycetes. Early diagnosis and immediate, effective treatment are the key for cure of the disease.