Cutaneous mucormycosis as a presenting feature of type 1 diabetes in a boy - case report and review of the literature

J Pediatr Endocrinol Metab. 2018 Jun 27;31(6):689-692. doi: 10.1515/jpem-2017-0404.

Abstract

Background: Mucormycosis is a potentially fatal complication of diabetes. The rhino-orbito-cerebral form is the most common presentation, however, rarely other types can also be seen.

Case presentation: We describe the case of a 4½ -year-old boy not previously known to be a diabetic who presented to the plastic surgery department for gangrene of the left middle finger with surrounding erythema and induration. After the diagnosis of diabetes and initial treatment, pus from the wound showed broad aseptate hyphae suggestive of mucormycosis which was further confirmed on culture. Aggressive surgical debridement including amputation, antifungal treatment and glycemic control achieved a complete cure.

Conclusions: Cutaneous mucormycosis is a rare complication of type 1 diabetes mellitus and can even be seen at the onset of diabetes. High index of suspicion, timely antifungal treatment and aggressive surgical debridement usually lead to recovery in the localized form of the disease.

Keywords: cutaneous; mucormycosis; skin; type 1 diabetes mellitus; zygomycosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Amputation, Surgical
  • Antifungal Agents / therapeutic use
  • Child, Preschool
  • Debridement
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / diagnosis*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / surgery
  • Diagnosis, Differential
  • Fingers / microbiology
  • Fingers / pathology
  • Fingers / surgery
  • Hand Deformities, Acquired / drug therapy
  • Hand Deformities, Acquired / microbiology
  • Hand Deformities, Acquired / pathology
  • Hand Deformities, Acquired / surgery
  • Humans
  • Male
  • Mucormycosis / diagnosis*
  • Mucormycosis / drug therapy
  • Mucormycosis / etiology*
  • Mucormycosis / surgery

Substances

  • Antifungal Agents