Management of Isolated Mucormycosis on the Upper Extremity, A Rare Case Report
TL;DR
Early diagnosis and a multidisciplinary approach are crucial in managing mucormycosis, especially in immunocompromised individuals and combined treatment with surgery, systemic and topical antifungals, and adjunctive therapies such as hyperbaric oxygen may prevent limb loss and improve outcomes.
Abstract
AbstractObjective:Mucormycosis is an invasive fungal infection characterized by rapid tissue necrosis and high mortality, particularly in immunocompromised patients. Upper extremity involvement is extremely rare. Herein, we present a case of cutaneous mucormycosis in the left forearm of a patient with a history of bone marrow transplantation and discuss the diagnosis and treatment process in light of the literature.Methods:A 66-year-old male patient with a history of bone marrow transplantation presented with redness and pain in the left volar forearm after peripheral venous access. Necrosis rapidly progressed over two weeks, extending to the wrist. Surgical debridement was performed. Tissue biopsy and wound culture confirmed mucormycosis.Results:On the second postoperative day, new necrotic foci and hyperemia developed around the wound. The diagnosis of mucormycosis was confirmed by histopathology and culture. The patient received intravenous antifungal therapy, adjunctive hyperbaric oxygen therapy, and topical antifungal wound care. By day 40 of follow-up, epithelialization from the periphery to the center of the defect was observed with no further necrotic progression.Conclusion:Early diagnosis and a multidisciplinary approach are crucial in managing mucormycosis, especially in immunocompromised individuals. Combined treatment with surgery, systemic and topical antifungals, and adjunctive therapies such as hyperbaric oxygen may prevent limb loss and improve outcomes.Keywords: Mucormycosis, upper extremity infection, immunosuppression, debridement, hyperbaric oxygen.