Mucormycosis of the anterior chest wall presenting as a soft tissue tumour
Abstract
Mucormycosis is a fungal infection caused by order Mucorales in humans. It commonly affects immunocompromised individuals, usually following trauma, and is associated with high rates of mortality despite the use of modern antifungal therapy and debridement. This report describes a case of the mucormycosis that presented as a non-healing ulcer over the chest wall (an extremely rare site for this lesion) which appeared to be a soft tissue tumour. The patient was immunocompetent and had no history of trauma. Repeated biopsies suggested there were only inflammatory changes but a fungal culture confirmed Rhizopus microsporus. The ulcer was managed successfully with high doses of intravenous Amphotericin B and aggressive surgical debridement.
Of the various fungi that present as cutaneous infections, mucormycosis still often remains undiagnosed. Mucormycosis is caused by fungi placed in the order Mucorales of the subphylum Mucoromycotina. Cutaneous mucormycosis has been reported in association with diabetes,1 malignancies,2 chronic immunosuppressive states3 and following transplantation.4 It usually develops following trauma5,6,7 but can also occur as a nosocomial infection.8,9 It is a very invasive form of fungal infection, with mortality rates in the range of 15–40%, rising to as much as 60% in severely immunocompromised patients, although incidence of cutaneous mucormycosis in these patients is very low.10,11,12 Cutaneous infection usually involves the extremities rather than the trunk, but it has been reported that disseminated or pulmonary mucormycosis can spread to the chest wall.13 Isolated chest wall involvement is extremely rare.14
Register now to continue reading
Thank you for visiting Wound Central and reading some of our peer-reviewed resources for wound care professionals. To read more, please register today. You’ll enjoy the following great benefits:
What's included
-
Access to clinical or professional articles
-
New content and clinical updates each month