Management and Surgical Dressing Protocol for Cutaneous Mucormycosis After a Blast Injury: A Case Report.

BACKGROUND Mucormycosis is known for being an aggressive fungal infection that is associated with high morbidity and mortality. Due to its nonspecific presentation, diagnosis is challenging, and a high level of suspicion is required to optimize patient outcomes. This report discusses a case of mucormycosis infection in a bomb blast victim who was identified early, treated promptly, and was eventually discharged 1 month after admission. CASE REPORT We report the case of a 40-year-old male patient who sustained a bomb blast injury. He arrived at a tertiary hospital 3 days after the injury, in pain and tachycardic, with multiple wounds and shrapnel covered in soil. During hospitalization, he developed generalized symptoms, and his wounds were not improving, having more discharge and necrosis, despite receiving appropriate empirical antibiotics. Empirical anti-fungal therapy was started due to suspicion of mucormycosis, which was later confirmed histopathologically. The patient has completed 32 days of anti-fungal therapy, 11 intraoperative sessions of surgical debridement, and a change of dressing utilizing our personally developed protocol. He was discharged 44 days after admission, living independently with an excellent quality of life. CONCLUSIONS Mucormycosis is a rare yet fatal infection. A definitive diagnosis is established based on histopathological evidence or positive culture of the suspected debrided tissue. The cornerstone of treatment for mucormycosis is the early initiation of amphotericin B deoxycholate and frequent, aggressive debridement of infected tissue.