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Surgical Closure of Equine Abdomen, Prevention, and Management of Incisional Complications
Published on: May 10, 2024
Post operative abdominal wall mucormycosis infection after laparotomy for bowel perforation
Neha Kumta1, Lawrence Huang2, Gururaj Nagaraj1
1Intensive Care Department, Sunshine Coast University Hospital, Australia.
Abstract:
Mucormycosis is a devastating disease with a high mortality rate, typically affecting immunosuppressed individuals. Postoperative surgical site infections due to mucromycosis are rare, with only a handful of cases reported in the literature. Here, we describe a fatal case of post operative abdominal wound infection caused by mucormycosis in an immunocompetent man in his 70 s, who developed the infection following a laparotomy for bowel perforation. Initially, the growth of fungal species from a superficial wound swab was not considered significant until the patient exhibited signs of worsening sepsis. Limited operative debridement was performed for prognostication, in accordance with the family's wishes. There was evidence of extensive significant invasive fungal infection, marked by necrosis extending into the abdominal wall fat and muscle. The patient was then transitioned to comfort measures and subsequently died. This case emphasizes the importance of maintaining a high level of clinical suspicion for mucormycosis, even in patients with minimal risk factors, and highlights the importance of prompt and aggressive treatment.
Insights
Mucormycosis, a rare postoperative abdominal wound infection, can be fatal even in immunocompetent patients. Prompt diagnosis and aggressive treatment are crucial for managing this devastating fungal disease.
Area of Science:
- Mycology
- Infectious Diseases
- Surgical Pathology
Background:
- Mucormycosis is a severe fungal infection with high mortality, predominantly affecting immunocompromised individuals.
- Postoperative surgical site infections caused by mucormycosis are exceptionally rare, with limited documented cases.
Observation:
- A case of fatal postoperative abdominal wound mucormycosis in an immunocompetent elderly male following bowel perforation surgery is presented.
- Initial superficial wound swab results were dismissed until the patient developed severe sepsis, indicating extensive invasive fungal infection.
Findings:
- Necrosis extended into the abdominal wall's fat and muscle, confirming significant invasive fungal disease.
- Despite limited debridement, the infection progressed, leading to the patient's death.
Implications:
- This case underscores the necessity of high clinical suspicion for mucormycosis, irrespective of patient risk factors.
- Highlights the critical need for early and aggressive therapeutic interventions in suspected cases of invasive fungal infections.
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