Cunninghamella 속에 의해 발생한 다발성 원발성피부털진균증 1예 = A Case of Multiple Primary Cutaneous Mucormycosis Caused by Cunninghamella Species

다국어 초록 (Multilingual Abstract)

A 71-year-old female presented with erythematous ulcerative patches on her right cheek, chest and right upper arm. She admitted to neurosurgery intensive care unit (NSICU) with mental change related to intracerebral hemorrhage. She had no underlying disease. Histopathologic examination of her right upper arm showed multiple non-septated broad hyphae with right-angled branching in dermis. She was diagnosed as primary cutaneous mucormycosis. The fungal culture demonstrated Cunninghamella species. We postulated that mucormycosis occurred after inoculation of fungi following fall down trauma. Mucormycosis, which commonly affects immunocompromised patient, is a rare fungal infection caused by the order Mucorales. Cutaneous mucormycosis is caused either by direct inoculation of fungal spores or by hematologic spread from another primary source. Clinical manifestations are various from indolent ulceration to rapidly progressive necrosis. Mucormycosis can be diagnosed based on the histologic findings and the fungal culture. Mucormycosis by Cunninghamella species have been increasingly reported, but most of them are pulmonary mucormycosis in immunocompromised patients. Herein, we report a rare case of multiple primary cutaneous mucormycosis caused by Cunninghamella species in a patient without underlying disease.

참고문헌 (Reference)

1 Quinio D, "Zygomycosis caused by Cunninghamella bertholletiae in a kidney transplant recipient" 42 : 177-180, 2004

2 Ribes JA, "Zygomycetes in human disease" 13 : 236-301, 2000

3 Verma R, "Rare case of primary cutaneous mucormycosis of the hand caused by Rhizopus microsporus in an immunocompetent patient" 53 : 66-69, 2014

4 Kaur R, "Primary cutaneous mucormycosis in a patient with burn wounds due to Lichtheimia ramosa" 178 : 291-295, 2014

5 Chambers CJ, "Primary cutaneous mucormycosis at sites of insulin injection" 64 : e79-e81, 2011

6 Ryan ME, "Primary cutaneous mucormycosis : superficial and gangrenous infections" 1 : 110-114, 1982

7 Hicks WL, Jr, "Primary cutaneous mucormycosis" 16 : 265-268, 1995

8 Aziz S, "Mucormycosis in patients with multiple-organ failure" 119 : 1189-1191, 1984

9 Prabhu RM, "Mucormycosis and entomophthoramycosis:a review of the clinical manifestations, diagnosis and treatment" 10 (10): 31-47, 2004

10 Adam RD, "Mucormycosis : emerging prominence of cutaneous infections" 19 : 67-76, 1994

11 Roden MM, "Epidemiology and outcome of zygomycosis : a review of 929 reported cases" 41 : 634-653, 2005

12 Motohashi K, "Cutaneous zygomycosis caused by Cunninghamella bertholletiae in a patient with chronic myelogenous leukemia in blast crisis" 84 : 447-448, 2009

13 Flagothier C, "Cutaneous mucormycosis" 16 : 77-81, 2006

14 Khardori N, "Cutaneous Rhizopus and Aspergillus infections in five patients with cancer" 125 : 952-956, 1989

15 Mostaza JM, "Cutaneoarticular mucormycosis due to Cunninghamella bertholletiae in a patient with AIDS" 11 : 316-318, 1989

16 Boyce JM, "Cunninghamella bertholletiae wound infection of probable nosocomial origin" 74 : 1132-1135, 1981

17 Almaslamani M, "An increasing trend of cutaneous zygomycosis caused by Mycocladus corymbifer(formerly Absidia corymbifera) : report of two cases and review of primary cutaneous Mycocladus infections" 47 : 532-538, 2009