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CC BY-NC 4.0 · Arch Plast Surg 2021; 48(02): 231-236
DOI: 10.5999/aps.2020.00549
Extremity/Lymphedema
Case Report

Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients

Kathleen M. Coerdt 
Georgetown University School of Medicine, Washington, D.C. USA
,
Elizabeth G. Zolper 
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USA
,
Amy G. Starr 
Department of Pathology, MedStar Georgetown University Hospital, Washington, D.C., USA
,
Kenneth L. Fan 
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USA
,
Christopher E. Attinger 
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USA
,
Karen K. Evans 
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USA
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Mucormycosis is an invasive, rapidly progressive, life-threatening fungal infection, with a propensity for diabetic, immunosuppressed, and trauma patients. The classic rhinocerebral variation is most common in diabetic patients. While the cutaneous form is usually caused by direct inoculation in immunocompetent patients. Cutaneous mucormycosis manifests in soft tissue and risks involvement of underlying structures. Tibial osteomyelitis can also occur secondary to cutaneous mucormycosis but is rare. Limb salvage is typically successful after lower extremity cutaneous mucormycosis even when the bone is involved. Herein, we report two cases of lower extremity cutaneous mucormycosis in diabetic patients that presented as acute worsening of chronic pretibial ulcers. Despite aggressive antifungal therapy and surgical debridement, both ultimately required amputation. Such aggressive presentation has not been reported in the absence of major penetrating trauma, recent surgery, or burns.

Keywords

Mucormycosis - Leg ulcer - Amputation - Diabetes mellitus - Wound infection


Publication History

Received: 28 March 2020

Accepted: 12 August 2020

Article published online:
07 March 2022

© 2021. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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