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A case report of cutaneous mucormycosis of the hand after minor trauma in a patient with acute myeloid leukaemia

机译:急性髓性白血病患者轻度创伤后手部皮肤毛霉菌病的一例报道

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BackgroundMucormycosis is a rare but life-threatening infection, caused by fungi of the Mucorales order, which can be found in soil, rotting leaves or on animals. Through characteristic angioinvasive growth, infections with mucor spores can occur as a pulmonary, rhinocerebral or cutaneous form. Infections mainly affect immunosuppressed patients with a history of uncontrolled diabetes or haematological malignancies, among others. Treatment is multimodal and requires an immediate combination of intravenous amphotericin B therapy and serial surgical debridements. Only a limited number of cases of cutaneous mucormycosis of the hand have been documented and described previously.Case presentationWe report a cutaneous mucormycosis in an elderly patient with a therapy-resistant acute myeloid leukaemia after a minor trauma on his right hand, sustained whilst gardening. The fungal infection was treated with serial radical debridements, vacuum-assisted negative-pressure wound closure technique and intravenous antifungals. Despite successful eradication of the fungal infection, a palliative open wound care concept was implemented during the terminal course of the patient's leukaemia.ConclusionsCutaneous mucormycosis is a rare but fulminant fungal infection mostly affecting immunosuppressed patients. Survival is possible when diagnosed and treated early, yet mortality rates remain high.
机译:背景霉菌病是一种罕见的但威胁生命的感染,由毛科氏菌引起,可在土壤,腐烂的叶子或动物身上发现。通过特征性的血管侵入性生长,粘液孢子的感染可以肺,鼻脑或皮肤形式发生。感染主要影响具有不受控制的糖尿病或血液恶性肿瘤病史的免疫抑制患者。治疗是多模式的,需要立即使用静脉内两性霉素B治疗和一系列外科清创术相结合。先前仅记录和描述了手部皮肤粘液霉菌病的少数病例。病例介绍我们报道了一名右手轻度创伤后具有治疗抗性的急性髓细胞性白血病的老年患者的皮肤粘液霉菌病,在园艺期间持续存在。真菌感染通过一系列的根治性清创术,真空辅助负压伤口闭合技术和静脉内抗真菌药进行治疗。尽管成功地根除了真菌感染,但在患者白血病的终末过程中仍实施了姑息性开放伤口护理概念。结论慢性霉菌病是一种罕见但暴发性真菌感染,主要影响免疫抑制患者。尽早诊断和治疗可以生存,但是死亡率仍然很高。

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