Cutaneous Mucormycosis following a Spider Bite: A Rare and Challenging Case

Mucormycosis is a rare and life-threatening fungal infection caused by Mucorales, primarily affecting immunocompromised individuals such as those with diabetes or organ transplants. While it typically involves the sinuses, lungs, or central nervous system, cutaneous mucormycosis following minor trauma, including spider bites, is extremely uncommon.

We report the case of a 44-year-old Palestinian man with uncontrolled diabetes mellitus and a history of renal transplant on immunosuppressive therapy who developed progressive pain, swelling, and erythema of the right forearm after a spider bite. Despite empirical antibiotic therapy, the lesion worsened, with necrosis and bullae formation. Biopsy confirmed mucormycosis, and cultures also revealed methicillin-resistant Staphylococcus aureus (MRSA). The patient was treated with systemic antifungal therapy (amphotericin B deoxycholate) and targeted antibiotics, alongside repeated surgical debridement and vacuum-assisted closure wound care. His condition improved significantly, and he is currently awaiting skin grafting with no residual infection.

This case highlights an atypical presentation of cutaneous mucormycosis following a spider bite in an immunocompromised patient. Early recognition, prompt initiation of antifungal therapy, and aggressive surgical intervention are crucial for favorable outcomes in such rare and complex infections.