Cutaneous mucormycosis caused by Rhizopus microsporus in an immunocompetent patient A case report and review of literature

Rationale: Cutaneous mucormycosis is an uncommon disease and occurs rarely in immunocompetent patients. Patient concerns: We reported the case of a 37-year-old man presenting with a skin lesion on the left side of the chest wall with no history of trauma or primary diseases. He was firstly misdiagnosed as tuberculosis and the proper treatment was thus delayed. Diagnoses: Histopathological examination and fungal culture of the lesion confirmed cutaneous mucormycosis. The isolate was identified as Rhizopus microspores by ITS sequencing. Interventions: The patient was treated with oral posaconazole 400 mg bid for 150 days. Outcomes: The patient recovered satisfactorily. No recurrence was found during the follow-up and no side effect of liver function was found. Lessons: This case helps doctors to consider the possibility of serious fungal infection in immunocompetent patients. It also suggested that posaconazole could be an alternative choice for the treatment of mucormycosis considering the severe side effect of Amphotericin B.