Mucormycosis following a facial trauma: Report of a case

Zygomycosis are invasive infections due to the proliferation in the tissues of the cosmopolitan moulds of the genera Rhizopus, Mucor, Rhizomucor, Absidia. They are rare and mainly occur in diabetic, immunosuppressed or post-traumatic patients. Their outcome is usually fatal. The authors report a zygomycosis case in a patient admitted for a facial trauma consecutive to a road accident and discuss the diagnosis and therapeutic features of zygomycosis complicating facial wounds. Case report. - A 50-year-old tunisian mate patient presented with multiple contusions and wounds of the right hemiface, following a road traffic accident. The patient underwent suture of wounds and received antibiotics. Six days Later, an important edema of the face appeared together with purple coloration of the tegument. The symptoms were suggestive of diffuse anaerobic bacterial cellulitis. Despite a broad-spectrum antibiotic regimen and repeated excisions of necrotic tissues, the lesions worsened and extended further. Mycological and pathological examinations were carried out and concluded to a zygomycosis. Culture yielded colonies of Rhizopus arrhizus (syn. Rhizopus oryzae). However and despite amphotericin B and surgical debridement, lesions extended to the orbital region leading to an exophtalmus and then to a cerebral involvement and the patient ultimately died. (C) 2008 Elsevier Masson SAS. Tous droits reserves.