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. 2009:2009:bcr10.2008.1170.
doi: 10.1136/bcr.10.2008.1170. Epub 2009 Apr 28.

Mucormycosis complicating lower limb crash injury in a multiple traumatised patient: an unusual case

Mariusz Stasiak  1 , Alfred Samet, Jerzy Lasek, Maria Wujtewicz, Zbigniew Witkowski, Jolanta Komarnicka, Katarzyna Golabek-Dropiewska, Bartosz Rybak, Marta Gross, Wojciech Marks
Affiliations

Mucormycosis complicating lower limb crash injury in a multiple traumatised patient: an unusual case

Mariusz Stasiak et al. BMJ Case Rep. 2009.

Abstract

Necrotising skin and soft tissues infections are most commonly bacterial in origin. However, saprophytic fungi of the class Zygomycetes, family Mucoraceae, can cause highly aggressive infections (mucormycoses) mainly in immunocompromised patients. Severe trauma is one of the major risk factors for mucormycosis. Fungal traumatic wound infection is an unusual complication associated with crash limb injury. This report describes a case of serious necrotising soft tissue infection caused by Mucor sp following primary fungal environmental wound contamination in a multiply injured patient. Despite undelayed diagnosis and proper treatment (surgical debridement and limb amputation, amphotericin B therapy) the patient presented a fatal outcome.

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Figures

Figure 1
Figure 1
x Ray examination.
Figure 2
Figure 2
Local extremity condition with rapidly progressive skin and subcutaneous tissue necrosis surrounded by massive inflammatory infiltrate.
Figure 3
Figure 3
Wound condition after surgical debridement.
Figure 4
Figure 4
Fungal hyphae in direct microscopic examination (H&E, ×400).
See this image and copyright information in PMC

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