C Reinbold1, M Derder2, M Hivelin2, C Ozil2, A Al Hindi2, L Lantieri2. 1. Department of Plastic Reconstructive and Aesthetic Surgery, Georges-Pompidou European Hospital, 20, rue Leblanc, 75015 Paris, France. Electronic address: c.reinbold@hotmail.fr. 2. Department of Plastic Reconstructive and Aesthetic Surgery, Georges-Pompidou European Hospital, 20, rue Leblanc, 75015 Paris, France.
Abstract
BACKGROUND: Mucormycosis is a very rare infection caused by fungi from the order Mucorales, it rarely involves the skin. We report a case of necrotizing fasciitis of the upper limb which required an aggressive surgical debridement, antifungal therapy and coverage of the defect with a free DIEP flap, a review of the literature was also done regarding indications of reconstruction with free flaps. CASE PRESENTATION: Here we present a case of cutaneous mucormycosis of the right upper limb in a 49-year-old immunocompetent woman after having an open fracture associated with massive contamination during a motor vehicle collision. In early postoperative period, she had multiple skin necrotic lesions. Serial surgical debridements were performed and ended up with interscapular-thoracic amputation associated with a total mastectomy. Following diagnosis confirmation of mucormycosis infection, the patient was started on antifungal therapy for several months. After disease control, the large defect was successfully covered by a DIEP flap. CONCLUSION: Cutaneous mucormycosis requires antifungal therapy along with aggressive debridement, reconstruction by a free flap seems to be a good solution to cover these large defects.
BACKGROUND:Mucormycosis is a very rare infection caused by fungi from the order Mucorales, it rarely involves the skin. We report a case of necrotizing fasciitis of the upper limb which required an aggressive surgical debridement, antifungal therapy and coverage of the defect with a free DIEP flap, a review of the literature was also done regarding indications of reconstruction with free flaps. CASE PRESENTATION: Here we present a case of cutaneous mucormycosis of the right upper limb in a 49-year-old immunocompetent woman after having an open fracture associated with massive contamination during a motor vehicle collision. In early postoperative period, she had multiple skin necrotic lesions. Serial surgical debridements were performed and ended up with interscapular-thoracic amputation associated with a total mastectomy. Following diagnosis confirmation of mucormycosis infection, the patient was started on antifungal therapy for several months. After disease control, the large defect was successfully covered by a DIEP flap. CONCLUSION:Cutaneous mucormycosis requires antifungal therapy along with aggressive debridement, reconstruction by a free flap seems to be a good solution to cover these large defects.