Related Experiment Videos
Cutaneous zygomycosis in a diabetic HTLV-I-seropositive man
R Clark1, D L Greer, T Carlisle
1Section of Infectious Disease, Tulane University, New Orleans, LA.
Abstract:
Zygomycosis, an invasive fungal infection, is usually seen in persons with diabetes, particularly in those with diabetic ketoacidosis. The infection most frequently occurs in the rhinocerebral region and rapidly spreads, causing a swift demise. Rarely, the infection is confined to the cutaneous tissues. We describe a 31-year-old man seropositive for human T lymphotropic virus type I who had diabetic ketoacidosis with zygomycosis confined to the right arm. The lesion was presumed initially to be a bacterial infection but did not respond to conventional antimicrobial therapy. The arm lesion was cultured, and Rhizopus arrhizus was isolated. The patient responded well to a combination of amphotericin B and extensive surgical debridements. Our case emphasizes the importance of maintaining a high index of suspicion of cutaneous zygomycotic infections in the impaired host, especially of those in patients with diabetes, who do not respond to initial antimicrobial treatment.
Insights
Zygomycosis, a fungal infection, can occur in patients with diabetes. This case highlights a rare instance of cutaneous zygomycosis in a diabetic patient, emphasizing early diagnosis and treatment for better outcomes.
Area of Science:
- Mycology
- Infectious Diseases
- Dermatology
Background:
- Zygomycosis is an invasive fungal infection often associated with uncontrolled diabetes mellitus, particularly diabetic ketoacidosis.
- It typically affects the rhinocerebral region, leading to rapid progression and high mortality.
- Cutaneous involvement is rare but can occur in immunocompromised individuals.
Observation:
- A 31-year-old human T lymphotropic virus type I (HTLV-I) seropositive male presented with diabetic ketoacidosis.
- He developed a cutaneous lesion on his right arm, initially misdiagnosed as a bacterial infection.
- The lesion, caused by Rhizopus arrhizus, did not respond to standard antibiotic treatment.
Findings:
- The patient was diagnosed with zygomycosis confined to the cutaneous tissues of the right arm.
- Successful treatment involved a combination of amphotericin B and aggressive surgical debridement.
- Isolation of Rhizopus arrhizus confirmed the fungal etiology.
Implications:
- This case underscores the importance of considering zygomycosis in diabetic patients with non-responsive skin lesions.
- Early suspicion and appropriate diagnostic measures are crucial for managing cutaneous zygomycosis.
- Prompt antifungal therapy and surgical intervention can lead to favorable outcomes in immunocompromised hosts.