Post-operative Abdominal Wall Mucormycosis-a Case Series
Prabhdeep Singh Nain1, Harish Matta1, Kuldip Singh1
1Department of Surgery, Dayanand Medical College & Hospital, Ludhiana, Punjab 141001 India.
Abstract:
Mucormycosis is caused by saprophtytic fungi which cause acute invasive zygomycosis. It clinically presents with necrosis, and on histopathology, acute and chronic infiltrates are seen. It rarely infects a healthy host, but is devastating in an immunocompromised host. We studied five cases with post-operative abdominal wall mucormycosis, three females and two males. Three patients were post-operative while the other two had mucormycosis following trauma and infection was found in sutured wound. All were initially diagnosed as cases of necrotizing fasciitis. Two patients eventually survived after intensive medical therapy and extensive debridements.
Insights
Mucormycosis, a fungal infection, can cause severe abdominal wall necrosis, especially in immunocompromised patients. Early diagnosis and aggressive treatment, including surgery, are crucial for survival.
Area of Science:
- Mycology
- Infectious Diseases
- Surgical Pathology
Background:
- Mucormycosis is an acute, invasive fungal infection caused by saprophytic fungi.
- It primarily affects immunocompromised individuals, presenting with necrosis.
- Diagnosis can be challenging, often initially mistaken for necrotizing fasciitis.
Purpose of the Study:
- To report on five cases of post-operative abdominal wall mucormycosis.
- To highlight the clinical presentation and diagnostic challenges.
- To discuss treatment outcomes in affected patients.
Main Methods:
- Retrospective case series of five patients with abdominal wall mucormycosis.
- Review of clinical presentations, initial diagnoses, and treatment interventions.
- Histopathological examination findings were considered.
Main Results:
- Five cases (3 female, 2 male) of abdominal wall mucormycosis were identified.
- Three cases were post-operative, and two followed trauma with wound infection.
- All cases were initially misdiagnosed as necrotizing fasciitis.
- Two patients survived after intensive medical therapy and debridement.
Conclusions:
- Abdominal wall mucormycosis is a rare but serious complication, particularly in post-operative or post-traumatic settings.
- High index of suspicion is needed for early diagnosis, differentiating it from necrotizing fasciitis.
- Aggressive surgical debridement and medical management are essential for improving patient outcomes.
