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Primary Cutaneous Mucormycosis Caused by Rhizopus oryzae: A Case Report and Review of Literature

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Abstract

Mucormycosis is an invasive infection caused by opportunistic fungi. Rhizopus, Lichtheimia, Mucor and Rhizomucor are the most common isolated genera. Primary cutaneous mucormycosis is usually related to traumatic injuries, but immunocompromised cases are associated with underlying conditions such as diabetes mellitus and malignancies. The treatment of choice is surgical debridement and liposomal amphotericin B. We present a 40-year-old male with fever and a painful necrotic lesion on the middle back and history of poorly controlled diabetes mellitus. Rhizopus oryzae was isolated and identified using an internal transcribed spacer regions ITS1 and ITS2. An initial good response to treatment was observed; however, 7 days later a diabetic ketoacidosis due to poor adherence to treatment caused a lethal outcome.

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References

  1. London V, Chong S. Cutaneous mucormycosis: a case report. Cutis. 2012;89:167–8.

    PubMed  Google Scholar 

  2. Korabecná M, Liska V, Fajfrlík K. Primers ITS1, ITS2 and ITS4 detect the intraspecies variability in the internal transcribed spacers and 5.8S rRNA gene region in clinical isolates of fungi. Folia Microbiol. 2003;48:233–8.

    Article  Google Scholar 

  3. Gomes MZ, Lewis RE, Kontoyiannis DP. Mucormycosis caused by unusual mucormycetes, non-Rhizopus, Mucor, and Lichtheimia species. Clin Microbiol Rev. 2011;24:411–45.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, Sein M, Sein T, Chiou CC, Chu JH, Kontoyiannis DP, Walsh TJ. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005;41:634–53.

    Article  PubMed  Google Scholar 

  5. Bonifaz A, Tirado-Sánchez A, Calderón L, Romero-Cabello R, Kassack J, Ponce RM, Mena C, Stchigel A, Cano J, Guarro J. Mucormycosis in children: a study of 22 cases in a Mexican hospital. Mycoses. 2014;57:79–84.

    Article  PubMed  Google Scholar 

  6. Bonifaz A, Tirado-Sánchez A, Calderón L, Ponce RM. Cutaneous mucormycosis: mycological, clinical, and therapeutic aspects. Curr Fungal Infect Rep. 2015;9:229–37.

    Article  Google Scholar 

  7. Skiada A, Rigopoulos D, Larios G, Petrikkos G, Katsambas A. Global epidemiology of cutaneous zygomycosis. Clin Dermatol. 2012;30:628–32.

    Article  PubMed  Google Scholar 

  8. Gelman A, Valdes R, Bhattacharyva S, Yosipovitch G. A case of primary cutaneous mucormycosis caused by minor trauma. Dermatol Online J. 2015;21:1–3.

    Google Scholar 

  9. Lelievre L, Garcia-Hermoso D, Abdoul H, Hivelin M, Chouaki T, Toubas D, Mamez AC, Lantieri L, Lortholary O, Lanternier F. Posttraumatic mucormycosis: a nationwide study in France and review of the literature. Medicine. 2014;93:395–404.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Petrikkos G, Skiada A, Lortholary O, Roilides E, Walsh TJ, Kontoyiannis DP. Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis. 2012;54:23–34.

    Article  Google Scholar 

  11. De Telles Filho F, Coelho A, Porto E, Lameira RF, Freitas MM, Barboza J, Ramos JL. Subcutaneous mucormycosis caused by Rhizopus oryzae probable nosocomial acquired infection. Rev Inst Med Trop Sao Paulo. 1985;27:201–6.

    Article  Google Scholar 

  12. Song WK, Park HJ, Cinn YW, Rheem I, Pai H, Shin JH. Primary cutaneous mucormycosis in a trauma patient. J Dermatol. 1999;26:825–8.

    Article  CAS  PubMed  Google Scholar 

  13. Miyamoto H, Hayashi H, Nakajima H. Cutaneous mucormycosis in a patient with acute lymphocytic leukemia. J Dermatol. 2005;32:273–7.

    Article  PubMed  Google Scholar 

  14. Chan Y, Goldwater P, Saxon B. Successful treatment of cutaneous and subcutaneous zygomycosis in an immunosuppressed patient with aplastic anaemia. J Paediatr Child Health. 2007;43:87–9.

    Article  PubMed  Google Scholar 

  15. Romano C, Ghilardi A, Massai L, Capecchi PL, Miraccco C, Fimiani M. Primary subcutaneous zygomycosis due to Rhizopus oryzae in a 71-year-old man with normal immune status. Mycoses. 2007;50:82–4.

    Article  CAS  PubMed  Google Scholar 

  16. Salim R, Runco R, Alvarez C, Romano S, Charre M. Zigomicosis cutanea primaria por Rhyzopus oryzae en una niña con leucemia linfoblastica aguda tipo b. Bol Micol. 2008;23:35–41.

    Google Scholar 

  17. Wildenbeest JG, Oomen MW, Brüggemann RJ, de Boer M, Bijleveld Y, van den Berg JM, Kuijpers TW, Pajkrt D. Rhizopus oryzae skin infection treated with posaconazole in a boy with chronic granulomatous disease. Pediatr Infect Dis J. 2010;29:578–9.

    Article  PubMed  Google Scholar 

  18. Harman M, Uçmak D, Dal T. A rare case of mucormycosis in the scalp. Acta Med Port. 2013;26:754–7.

    PubMed  Google Scholar 

  19. Li H, Hwang SK, Zhou C, Du J, Zhang J. Cutaneous mucormycosis caused by Rhizopus oryzae: a case report and review of primary cutaneous mucormycosis in China over past 20 years. Mycopathologia. 2013;176:123–8.

    Article  PubMed  Google Scholar 

  20. Vinay K, Chandrasegaran A, Kanwar AJ, Saikia UN, Kaur H, Shivaprakash MR, Dogra S. Primary cutaneous mucormycosis presenting as a giant plaque: uncommon presentation of a rare mycosis. Mycopathologia. 2014;178:97–101.

    Article  PubMed  Google Scholar 

  21. Zaman K, Kaur H, Rudramurthy SM, Singh M, Parashar A, Chakrabarti A. Cutaneous mucormycosis of scalp and eyelids in a child with type I diabetes mellitus. Indian J Dermatol Venereol Leprol. 2015;81:275–8.

    Article  PubMed  Google Scholar 

  22. Kanemaru M, Tashima S, Yamazaki A, Masuda K, Nagoshi H, Kobayashi T, Kuroda J, Hiruma M, Taniwaki M, Katoh N. Disseminated mucormycosis due to Rhizopus oryzae diagnosed by skin biopsy. J Dermatol. 2015;42:100–1.

    Article  PubMed  Google Scholar 

  23. Johnson M, Fathi R, Alkousakis T. Primary cutaneous mucormycosis. J Drugs Dermatol. 2015;14:915–7.

    Google Scholar 

  24. Gardiner BJ, Simpson I, Khuu MH, Kidd SE, Lo CH, Jenkin GA. An unusual ulcer: a case of cutaneous mucormycosis caused by Rhizopus oryzae. Med Mycol Case Rep. 2015;7:8–11.

    Article  PubMed  Google Scholar 

  25. Lakshmi P, Kumarasamy S. Devastating posttraumatic primary cutaneous mucormycosis in a diabetic patient. J Sci Soc. 2016;43:85–8.

    Article  Google Scholar 

  26. Mantadakis E, Samonis G. Clinical presentation of zygomycosis. Clin Microbiol Infect. 2009;15:15–20.

    Article  PubMed  Google Scholar 

  27. Romanelli AM, Fu J, Herrera ML, Wickes BL. A universal DNA extraction and PCR amplification method for fungal rDNA sequence-based identification. Mycoses. 2014;57:612–22.

    Article  CAS  PubMed  Google Scholar 

  28. Kontoyiannis DP, Lewis RE. Invasive zygomycosis: update on pathogenesis, clinical manifestations, and management. Infect Dis Clin North Am. 2006;20:581–607.

    Article  PubMed  Google Scholar 

  29. Cornely OA, Arikan-Akdagli S, Dannaoui E, Groll AH, Lagrou K, Chakrabarti A, Lanternier F, Pagano L, Skiada A, Akova M, Arendrup MC, Boekhout T, Chowdhary A, Cuenca-Estrella M, Freiberger T, Guinea J, Guarro J, de Hoog S, Hope W, Johnson E, Kathuria S, Lackner M, Lass-Flörl C, Lortholary O, Meis JF, Meletiadis J, Muñoz P, Richardson M, Roilides E, Tortorano AM, Ullmann AJ, van Diepeningen A, Verweij P, Petrikkos G. ESCMID and ECMM joint clinical guidelines for the diagnosis and management of mucormycosis 2013. Clin Microbiol Infect. 2014;20:5–26.

    Article  CAS  PubMed  Google Scholar 

  30. Katragkou A, Walsh TJ, Roilides E. Why is mucormycosis more difficult to cure than more common mycoses? Clin Microbiol Infect. 2014;20:74–81.

    Article  PubMed  Google Scholar 

  31. Lewis RE, Kontoyiannis DP. Epidemiology and treatment of mucormycosis. Future Microbiol. 2013;8:1163–75.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We thank Cecilia González de Cossio and María Fernanda Ortega-Springall for her excellent medical assistance.

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Authors and Affiliations

  1. Servicio de Dermatología, Hospital General Dr. Manuel Gea González, 14080, Tlalpan, Mexico

    Erika Rodríguez-Lobato & Lourdes Ramírez-Hobak

  2. Departamento Medicina Interna, Hospital General Dr. Manuel Gea González, 14080, Tlalpan, Mexico

    Jorge E. Aquino-Matus

  3. Departamento de Infectología, Hospital General Dr. Manuel Gea González, 14080, Tlalpan, Mexico

    Juan P. Ramírez-Hinojosa & Víctor H. Lozano-Fernández

  4. Laboratorio de Bacteriología Intestinal, Hospital Infantil de México Dr. Federico Gómez, 06720, Cuauhtémoc, Mexico

    Juan Xicohtencatl-Cortes

  5. Departamento de Ecología de Agentes Patógenos, Hospital General Dr. Manuel Gea González, Sección XVI, 14080, Tlalpan, Mexico

    Rigoberto Hernández-Castro

  6. Sección de Micología, Hospital General Dr. Manuel Gea González, Sección XVI, 14080, Tlalpan, Mexico

    Roberto Arenas

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  1. Erika Rodríguez-Lobato
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  2. Lourdes Ramírez-Hobak
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Correspondence to Rigoberto Hernández-Castro.

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Rodríguez-Lobato, E., Ramírez-Hobak, L., Aquino-Matus, J.E. et al. Primary Cutaneous Mucormycosis Caused by Rhizopus oryzae: A Case Report and Review of Literature. Mycopathologia 182, 387–392 (2017). https://doi.org/10.1007/s11046-016-0084-6

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  • DOI: https://doi.org/10.1007/s11046-016-0084-6

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