Two Cases of Post-Traumatic Mucormycosis due to Mucor circinelloides: Salvage Therapy with a Combination of Adjunctive Therapies

Abstract

Mucormycosis is a rare, emerging angioinvasive infection caused by ubiquitous filamentous fungi. In recent decades, an increase in cutaneous or post-traumatic mucormycosis has been reported. We describe two cases of post-traumatic wound infections with Mucor circinelloides, a mucor species only rarely reported as a cause of post-traumatic mucormycosis. Often considered lethal, management required a combination of medical and surgical therapies to achieve a favorable outcome in both cases.

Figure 1

Partially closed amputation stump with drains in place (first case).

Figure 2

(a) Gray-brownish colony growth on Sabouraud dextrose agar. (b) Identification under a microscope in the lab (first case). Sporangium with spores on a branched sporangiophore.

Figure 3

Hematoxylin-eosin staining of tissue obtained from the post-traumatic stump on Day 24 after the trauma (first case). M circinelloides dimorphic phases with pauci-septated wide hyphae with right-angle branching are seen. Please note the absence of infiltration of the underlying muscle with inflammatory cells, in devitalised tissue.