Shingde Rashmi, Cui Rebecca, Perera Ruwan
Department of General Surgery, Dubbo Base Hospital, Dubbo, NSW 2830, Australia.
Case Rep Surg. 2022 Mar 22;2022:7005024. doi: 10.1155/2022/7005024. eCollection 2022.
Cutaneous mucormycosis is a rare infection by the class of fungi, which carries significant morbidity and mortality. While typically associated in patients with underlying immunocompromise (especially in the current era of COVID-19), it may also be seen in immunocompetent patients. We report a case of a healthy 4-year-old girl with acute right leg cellulitis and abscess formation, who required surgical debridement following poor response to antibiotic therapy and initial incision and drainage. Tissue histopathology returned cutaneous zygomycosis despite negative tissue cultures. At four-week follow-up, her wound was healed well. Clinicians should maintain a high degree of clinical suspicion for cutaneous mucormycosis given its potential for rapidly progressive and disseminated disease. Currently, the mainstay of diagnostic investigations is tissue histopathology, with a growing role for tissue fungal PCR. Treatment involves multidisciplinary management between surgeons and Infectious Diseases team to guide the role for surgical debridement and antifungal therapy.
皮肤毛霉病是一种由真菌引起的罕见感染，具有较高的发病率和死亡率。虽然通常与潜在免疫功能低下的患者相关（尤其是在当前新冠疫情时代），但在免疫功能正常的患者中也可能出现。我们报告一例健康的4岁女童，患有急性右腿蜂窝织炎并形成脓肿，在对抗生素治疗以及初始切开引流反应不佳后，需要进行手术清创。尽管组织培养结果为阴性，但组织病理学检查显示为皮肤接合菌病。在四周的随访中，她的伤口愈合良好。鉴于皮肤毛霉病有迅速进展和播散性疾病的可能性，临床医生应保持高度的临床怀疑。目前，诊断性检查的主要手段是组织病理学检查，组织真菌PCR的作用也日益重要。治疗需要外科医生和感染病团队进行多学科管理，以指导手术清创和抗真菌治疗的作用。
