Abstract
Introduction
Mucormycosis is a rare but serious sequelae of penetrating trauma [
1
,
2
,
3
,
4
,
5
]. In spite of aggressive management, mortality remains high due to dissemination of
infection. We completed a review of literature to determine the most optimal treatment
of cutaneous mucormycosis which occurs secondary to penetrating trauma.Methods
We completed a review regarding the management of mucormycosis in trauma patients.
We selected a total of 36 reports, of which 18 were case-based, for review.
Results
Surgical debridement is a primary predictor of improved outcomes in the treatment
of mucormycosis [
3
,
6
,
7
]. Anti-fungal therapy, especially lipid soluble formulation of Amphotericin B, is
helpful as an adjunct or when surgical debridement has been maximally achieved. Further
research is needed to fully evaluate the impact of topical dressings; negative pressure
wound therapy is helpful.Conclusion
An aggressive and early surgical approach, even at the expense of disfigurement, is
necessary to reduce mortality in the setting of cutaneous mucormycosis that results
from penetrating trauma [
4
,
8
,
9
]. Anti-fungal therapy and negative pressure wound therapy are formidable adjuncts.Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Mucormycosis: emerging prominence of cutaneous infections.Clin Infect Dis. 1994; 19: 67-76
- Mucormycosis in trauma patients.J Trauma. 1992; 31: 12-15
- Primary cutaneous mucormycosis: guide to surgical management.Ann Plast Surg. 2002; 49: 385
- Survival of a patient with trauma-induced mucormycosis using an aggressive surgical and medical approach.J Trauma. 2011; 70: 507-509
- Zygomycosis (mucormycosis). Incidence and Prevalence Data.2013
- Multiple modality treatment regimen in an aggressive resistant fungal hand infection: a case report.Hand. 2010; 5: 318-321
- Novel perspectives on mucormycosis: pathophysiology, presentation, and management.Clin Microbiol Rev. 2005; 18: 556-569
- Invasive fungal infections following combat-related injury.Mil Med. 2012; 177: 681
- Invasive mold infections following combat-related injuries.Clin Infect Dis. 2012; 55: 1441
- Necrotizing cutaneous mucormycosis after a tornado in Joplin, Missouri, in 2011.N Engl J Med. 2012; 367: 2214
- Mucormycosis: an emerging disease?.Clin Microbiol Infect. 2006; 12: 7
- Diagnosis of cutaneous mucormycosis due to Rhizopus microsporus by an innovative PCR-restriction fragment-length polymorphism method.Clin Infect Dis. 2005; 41: 1362-1365
- Fatal Actinomucor elegans var. kuwaitiensis Infection following Combat Trauma.J Clin Microbiol. 2009; 47: 3394-3399
- Mucormycosis after a tornado in Joplin, Missouri.N Engl J Med. 2013; 368: 1066
- Global epidemiology of cutaneous zygomycosis.Clin Dermatol. 2012; 30: 628
- Lower-extremity zygomycosis in a patient with traumatic injuries. A case report.J Bone Joint Surg Am. 2009; 91A: 686-692
- Recent advances in the management of mucormycosis: from bench to bedside.Clin Infect Dis. 2009; 48: 1743-1751
- Recent advances in the treatment of mucormycosis.Curr Infect Dis Rep. 2010; 12: 423-429
- Mucormycosis complicating lower limb crash injury in a multiple traumatised patient: an unusual case.BMJ Case Rep. 2009; : 2009
- Mucormycosis: its contemporary face and management strategies.Lancet Infect Dis. 2011; 11: 301-311
- Primary cutaneous mucormycosis in trauma patients.J Trauma. 1987; 27: 437-441
- The use of dilute Dakin's solution for the treatment of angioinvasive fungal infection in the combat wounded: a case series.Mil Med. 2013; 178: e503
- Invasive mucormycosis and aspergillosis in a healthy 22-year-old battle casualty: case report.Surg Infect. 2011; 12: 397-400
- Pathogenesis of mucormycosis.Clin Infect Dis. 2012; 54: S16-S22
- Update on mucormycosis pathogenesis.Curr Opin Infect Dis. 2013; 26: 508-515
- Epidemiology and clinical manifestations of mucormycosis.Clin Infect Dis. 2012; 54: S23-S34
- Surgical wound mucormycosis necessitating hand amputation: a case report.J Orthop Surg (Hong Kong). 2008; 16: 267
- Deferasirox as adjunctive therapy for mucormycosis.J Antimicrob Chemother. 2012; 67: 519-520
- Future directions in mucormycosis research.Clin Infect Dis. 2012; 54: S79-S85
- Multifocal cutaneous mucormycosis complicating polymicrobial wound infections in a tsunami survivor from Sri Lanka.Lancet. 2005; 365: 876-878
- Successful knee extensor mechanism reconstruction in a warfare-related open lower extremity injury complicated by mucormycosis infection: a case report.J Orthop Trauma. 2012; 26: E7-E10
- Ex vivo confocal microscopy: a new diagnostic technique for mucormycosis.Skin Res Technol. 2015; 22
- pH manipulation as a novel strategy for treating mucormycosis.Antimicrob Agents Chemother. 2015; 59: 6968-6974
- Pharmacokinetics and safety of posaconazole delayed-release tablets for invasive fungal infections.Clin Pharmacol. 2016; 8: 1-8
- Antifungal wound penetration of amphotericin and voriconazole in combat-related injuries: case report.BMC Infect Dis. 2015; 15: 184
- Cutaneous mucormycosis and motor vehicle accidents: findings from an Australian case series.Med Mycol. 2014; 52: 819-825
Article info
Publication history
Published online: April 11, 2016
Accepted:
March 7,
2016
Identification
Copyright
© 2016 Elsevier Ltd. All rights reserved.
