Cutaneous mucormycosis

Skin and soft tissue infections in solid organ transplants

PURPOSE OF REVIEW

Skin and soft tissue infections (SSTI) in solid organ transplant (SOT) recipients may be a great challenge for clinicians caring for SOT due to the involvement of both common and opportunistic pathogens associated with a blunted immune response. The purpose of this review is to outline current literature and describe open issues on the management of SSTI in this special population.

RECENT FINDINGS

Clinical presentation in SOT recipients can manifest as isolated skin lesions after primary inoculation or be the sign of a disseminated infection. Tissue samples for microscopy and histopathology are crucial to making an accurate diagnosis given the nonspecific and heterogeneous appearance of skin lesions. Multidisciplinary teams are required for a comprehensive diagnosis and management.

SUMMARY

SSTI are frequent contributors to morbidity and mortality in SOT. Specific research focused on the clinical presentation, risk factors and management in this special population is needed.

Simultaneous Infection of the Skin Surface and Dermal Tissue with Two Different Fungus Mimicking Pyoderma Gangrenosum: A Case Report

Mucormycosis is an opportunistic fungal infection driven by subphylum Mucormycotina. Cutaneous mucormycosis is the third most common presentation of mucormycosis, and its characterized presentation is an indurated plaque that rapidly evolves to necrosis. Trichophyton rubrum is one of the most common dermatophytes that mainly cause superficial infections and seldom induce deep infections. The present report presents a case of cutaneous fungal infection, in which two kinds of fungus were isolated, and the skin lesion mimicked pyoderma gangrenosum. Trichophyton rubrum was isolated from the crust and hyphae of subphylum Mucormycotina were found in dermal tissue. The irregular systemic and topical use of steroid therapy is the possible cause of the mixed fungal infection in this patient, suggesting the importance of regular steroid therapy.

Mucor as a cause of surgical site infection

Mucor is an uncommon cause of surgical site infection. We present such a case after intramedullary nailing of the femur and discuss its presentation and management.

The skin and soft tissue infections in hematological patients

PURPOSE OF REVIEW

Skin and soft tissue infections (SSTIs) in patients with hematological malignancies are frequent, but dedicated epidemiological studies are limited. The aim of this review is to provide updated description of the main etiological agents, differential diagnosis, and treatment.

RECENT FINDINGS

In addition to common causes of bacterial skin infections in any kind of patients, such as streptococci and staphylococci (the letter frequently resistant to methicillin), Pseudomonas aeruginosa is a frequent agent in patients with hematological malignancies, with high virulence and typical infection presenting as ecthyma gangrenosum. Among fungi, fusariosis is the mold infection most frequently associated with skin lesions, although other molds and yeasts (including Candida tropicalis) should be also considered. External infections associated with central venous catheters are frequent in the hematological setting, and in addition to staphylococci, Gram-negative bacteria, fungi, and even rapid growing nontuberculous mycobacteria should be considered. Immunodeficiency might either blunt the typical inflammatory response and make sign or symptoms less evident, or predispose the patients to rapid progression of skin infection to subcutaneous tissues or dissemination.

SUMMARY

SSTIs in hematology patients can be caused by various infectious agents resulting in similar clinical presentation. Rapid and accurate diagnosis is fundamental in order to reduce morbidity and mortality.

A 39-Year-Old Male Congenital Tricuspid Atresia Patient Who Presented with a New Axillary Lesion after an Orthotopic Heart Transplant

Mucormycosis is a rare and aggressive fungal infection, most often caused by species of the Mucor, Rhizomucor, Rhizopus, Absidia, and Cunninghamella genera. The condition most commonly affects patients with uncontrolled diabetes, HIV/AIDS, malignancy, and those receiving long-term immunosuppressive therapy. We report the case of a 39-year-old male with biopsy-proven cutaneous mucormycosis of the left axilla 4 months after an orthotopic heart transplant for congenital tricuspid atresia.