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J Hand Surg Am ; 44(7): 619.e1-619.e5, 2019 Jul.
Article in English | MEDLINE | ID: mdl-30344020

ABSTRACT

Cutaneous mucormycosis due to Saksenaea vasiformis species is exceptional. There have been about 40 reported cases worldwide, with most being fatal. We report an exceptional nonlethal case of mucormycosis due to S. vasiformis following a spider bite. The patient was in an immunosuppressed state owing to previous chemotherapy and diabetes mellitus. The origin of the inoculation was the bite of a Loxosceles laeta spider, which caused loxoscelism. The initial skin injury was quickly progressive, requiring amputation of the right upper limb. After surgical intervention and suitable antifungal treatment, the patient was discharged with resolution of accompanying pulmonary disease. Infections due to S. vasiformis are probably underdiagnosed. To avoid fatal outcomes, a high index of clinical suspicion in patients with quickly progressive necrotic lesions of soft tissues and systemic dissemination is important.


Subject(s)
Dermatomycoses/etiology , Dermatomycoses/pathology , Mucormycosis/etiology , Mucormycosis/pathology , Spider Bites/complications , Aged , Dermatomycoses/therapy , Humans , Male , Mucormycosis/therapy
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