Abstract
We report a case of rapidly progressing gangrenous cutaneous mucormycosis. A 53-year-old woman treated with hemodialysis visited our hospital because of gradually worsening lower abdominal pain. Computed tomography (CT) revealed acute generalized peritonitis arising from a sigmoid colon perforation, for which the patient emergently underwent a partial sigmoid colectomy and a single-barrel colostomy.
On postoperative day (POD) 21, the skin around the stoma became necrotic. A CT scan revealed air accumulation in the subcutaneous layer as well as intraperitoneal and retroperitoneal abscess formation, and bowel necrosis and perforation were subsequently suspected. In the second emergent operation, no bowel perforation was observed, but extensive necrosis and abscess formation of the abdominal wall were found. Therefore, resectional debridement of the necrotic abdominal wall and a left-sided colectomy concomitant with a new colostomy were performed.
Mucorales was detected in the mesenterium of the resected specimen by histological examination. Antifungal therapy for mucormycosis was initiated, but the patient died of multiple organ failure on POD74.
