Localized mucormycosis following intramuscular corticosteroid. Case report and review of the literature.

A case of subcutaneous localized mucormycosis infection which developed following intramuscular (IM) injection of corticosteroid in a patient with leukemia is presented. Aggressive treatment, which included wide local excision, systemic amphotericin-B, and chemotherapy for the leukemia, resulted in eradication of the infection and complete healing of the wound. A review of the literature revealed nine other patients with the localized subcutaneous form of mucormycosis (excluding patients with burns and rhinocerebral types) and six of those nine patients also survived the infection. It is possibly the mildness of the underlying predisposing factors that allows some of these patients to contain the infection at a single site. It is apparent from review of the literature that in subcutaneous localized forms of mucormycosis, the outcome has been generally good. This contrasts sharply with other clinical forms of mucormycosis infections where the underlying predisposing factors are usually severe and any kind of therapeutic approach has been almost always futile. Subcutaneous mucormycosis infection differs clinically and histopathologically from subcutaneous localized entomophthoromycosis which is seen predominantly in tropical countries. An attempt is made to clarify the terminology of these interesting fungi in language that is taxonomically up-to-date and still useful to clinicians.