Published online Mar 9, 2024. doi: 10.5492/wjccm.v13.i1.86866
Peer-review started: July 11, 2023
First decision: August 10, 2023
Revised: August 25, 2023
Accepted: December 1, 2023
Article in press: December 1, 2023
Published online: March 9, 2024
Processing time: 237 Days and 20.9 Hours
Mucormycosis is a rare, rapidly progressive and often fatal fungal infection. The rarity of the condition lends itself to unfamiliarity, delayed treatment, and poor outcomes. Diagnosis of fungal infections early enough to enable appropriate treatment occurs in less than half of affected patients.
An 11-year-old girl with a history of 15% total body surface area scald burns involving both lower limbs progressed to develop angioinvasive mucormycosis. This further led to a thrombosis of the right external iliac artery and vein and rapidly progressive necrosis of surrounding soft tissues. She also had dextrocardia and patent foramen ovale. A right hip disarticulation and serial aggressive debridements were performed but she went on to develop systemic sepsis with multisystem involvement and succumbed to the infection. Pathology revealed mucor species with extensive vascular invasion.
This case highlights the importance of maintaining vigilance for mycotic infections and acting appropriately when there are signs of fulminant wound infection.
Core Tip: Mucor species are known spread rapidly across fascial tissue planes and cause vascular invasion leading to high mortality rates despite aggressive surgical debridement. There are only rare reports of mucormycosis in burn wounds and most surgeons are not well-versed with its early features. This can lead to delay in diagnosis and institution of appropriate medical and surgical care. We came across one such case at our center recently, which prompted us to conduct a review of available literature on incidence of mucormycosis in burn wounds and available guidelines for management.