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Cutaneous Mucormycosis Following Polytrauma: A Multidisciplinary Approach

Summary

A 22-year-old man suffered severe injuries from a motorcycle-truck collision that damaged his perineal area and left thigh. Despite antibiotics and wound therapy, a dangerous fungal infection called mucormycosis developed in the wound. The medical team treated this by repeatedly removing infected tissue, using powerful antifungal medications (amphotericin B and posaconazole), and carefully managing the wound with special therapy before skin grafting, ultimately achieving successful healing.

Background

Cutaneous mucormycosis is a rare but aggressive fungal infection caused by angioinvasive fungi of the order Mucorales, traditionally seen in immunocompromised individuals. However, it can develop in immunocompetent hosts following traumatic inoculation through contaminated wounds, presenting clinical challenges due to rapid progression to necrosis and poor outcomes if diagnosis is delayed.

Objective

To present a case of cutaneous mucormycosis following severe polytrauma and demonstrate the effectiveness of a multidisciplinary approach incorporating early fungal identification, aggressive surgical debridement, systemic antifungal therapy, and staged wound management.

Results

Liposomal amphotericin B (5 mg/kg/day) for three weeks followed by oral posaconazole for ten weeks successfully controlled the infection. After fungal clearance, negative-pressure wound therapy was reinitiated, followed by split-thickness skin grafting and femoral nailing on hospital day 48, with adequate graft uptake and satisfactory recovery at three-month follow-up.

Conclusion

Early suspicion and identification of mucormycosis in non-healing contaminated trauma wounds is critical. A coordinated multidisciplinary approach combining aggressive surgical debridement, timely antifungal therapy, and carefully-timed adjunctive wound management such as NPWT is essential for achieving favorable outcomes in post-traumatic mucormycosis.
  • Published in:Cureus,
  • Study Type:Case Report,
  • Source: PMID: 40937271, DOI: 10.7759/cureus.89767
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