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Continuous debridement combined with short-term posaconazole therapy for cutaneous mucormycosis caused by Rhizopus oryzae infection secondary to acute myeloid leukemia: a case report

Summary

An 80-year-old patient with acute myeloid leukemia developed a serious fungal skin infection caused by Rhizopus oryzae on his lower leg. Doctors treated the infection by repeatedly cleaning out the infected tissue and giving him an antifungal medication called posaconazole for just one week. Despite the short treatment duration due to cost concerns, the patient’s wound gradually healed over four months through continued surgical care, showing that sometimes focused surgical treatment can be as effective as long-term medication.

Background

Cutaneous mucormycosis is a rare fungal infection that can occur in immunocompromised patients, particularly those with hematologic malignancies like acute myeloid leukemia. While cutaneous mucormycosis has lower mortality rates compared to other forms, delayed diagnosis and treatment can lead to dissemination to vital organs.

Objective

This case report describes the successful management of lower extremity cutaneous mucormycosis secondary to acute myeloid leukemia using sustained surgical debridement and short-term antifungal therapy with posaconazole.

Results

After continuous debridement for 4 months combined with 1 week of posaconazole therapy (due to financial constraints), the patient achieved successful wound healing. The lesion reduced in size from 7 cm × 7 cm to near complete resolution, and the patient was able to ambulate without complications from the fungal infection.

Conclusion

This case demonstrates that continuous surgical debridement combined with short-term antifungal therapy can effectively manage cutaneous mucormycosis, offering a more cost-effective strategy while maintaining treatment efficacy. Surgical intervention should be prioritized while considering reduced duration of systemic antifungal treatment.
  • Published in:Frontiers in Medicine,
  • Study Type:Case Report,
  • Source: PMID: 39512623, DOI: 10.3389/fmed.2024.1448147
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