Cutaneous mucormycosis in a patient with lupus nephritis: A case report and review of literature

Disseminated mucormycosis presenting as a renal mass in an human immunodeficiency virus-infected patient: A case report

Mucormycosis, an opportunistic fungal infection, is on the increase. Individuals at risk are those with diabetes mellitus, haematological malignancy, etc. Infections are uncommon in human immunodeficiency virus (HIV). Clinical presentations include rhinocerebral, pulmonary or disseminated forms. Risk factors should alert clinicians to a high index of suspicion. Prompt diagnosis, facilitated by radiological imaging and tissue sampling, with appropriate medical and surgical intervention can potentially improve patient outcomes. Here we describe a rare case of renal mass in a patient living with HIV presenting to casualty department with abdominal pain and fever. Radiological imaging showed a renal mass whilst histopathological findings were suggestive of mucormycosis. Management included antifungal therapy and subsequent nephrectomy. The patient improved significantly and was discharged home.

Cutaneous mucormycosis caused by Rhizopus microsporus in an immunocompetent patient: A case report and review of literature

RATIONALE

Cutaneous mucormycosis is an uncommon disease and occurs rarely in immunocompetent patients.

PATIENT CONCERNS

We reported the case of a 37-year-old man presenting with a skin lesion on the left side of the chest wall with no history of trauma or primary diseases. He was firstly misdiagnosed as tuberculosis and the proper treatment was thus delayed.

DIAGNOSES

Histopathological examination and fungal culture of the lesion confirmed cutaneous mucormycosis. The isolate was identified as Rhizopus microspores by ITS sequencing.

INTERVENTIONS

The patient was treated with oral posaconazole 400 mg bid for 150 days.

OUTCOMES

The patient recovered satisfactorily. No recurrence was found during the follow-up and no side effect of liver function was found.

LESSONS

This case helps doctors to consider the possibility of serious fungal infection in immunocompetent patients. It also suggested that posaconazole could be an alternative choice for the treatment of mucormycosis considering the severe side effect of Amphotericin B.