Twenty-five patients with
mucormycosis were seen at two university-affiliated hospitals from 1979 to 1993. These cases included 10 cutaneous, 9 rhinocerebral, and 3 disseminated
infections, as well as one case each of pulmonary, renal, and
peritoneal dialysis catheter-related infection. Eleven of the patients were diabetic and seven had
ketoacidosis, including four who became acidotic after admission to the hospital. The mortality rates associated with rhinocerebral, disseminated, and pulmonary
infections were 78%-100%, while those associated with cutaneous and miscellaneous forms were zero. In view of the prominence of cutaneous
infections, the 10 cases of cutaneous
mucormycosis (in addition to a case from a community hospital) are reported in detail. Systemic diseases were present in four of the 11 patients. Local factors leading to
infection were identified in nine of the cases and included motor vehicle accident-related and other trauma, surgery, a
spider bite, and an
intravenous infusion catheter. The cases of cutaneous
mucormycosis reported in the literature have been analyzed for identification of predisposing factors, treatment, and outcome. Aggressive surgical
debridement is the most important component of
therapy, and administration of
amphotericin B is a useful adjunct.
Skin grafting is useful as a method of repairing defects left by extensive
debridement.