Images in Clinical Medicine
Mucormycosis of the Hand and Forearm
N Engl J Med 1997; 337:1511November 20, 1997
- Article
Figure 1 Mucormycosis of the hand and forearm occurred in a 28-year-old woman after a thermal burn of the right thumb caused by tap water (Panel A). The patient had mild diabetes mellitus that had been treated with 10 mg of glyburide per day for four years. Hyphal invasion (arrows) and propagation through the blood vessels (Panel B, ×600) resulted in necrosis of the hand and forearm (Panel A) and was life threatening, necessitating amputation of her arm to above the elbow 26 days after the injury. The infection was caused by nonseptate hyphae of Rhizopus oryzae, 3 to 15 μm wide with irregular branching (Panel C, ×1300), and sporangia with many sporangiospores at the end of each hypha (Panel D, ×1200). These organisms were resistant to amphotericin B in vitro. Seventeen days after amputation, the stump was healed and the patient was sent home. On follow-up one year later no evidence of recurrence or fungal infection elsewhere was found.
Cobi Lidor, M.D., Ph.D.
James A. Nunley, M.D.
Duke University Medical Center, Durham, NC 27710- Citing Articles (1)
Citing Articles
1
Neil F. Jones, Eon K. Shin, SuRak Eo, Thomas E. Starzl. (2008) Successful Salvage of Mucormycosis Infection of the Forearm and Osteomyelitis of the Ulna. HAND 3:4, 332-336
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