Open AccessA Case Report: Utilization of Topical Amphotericin in Postoperative Mucormycosis
Author(s) -
Kenny Wang,
Jomel Jacinto,
Alex Davis,
Andrei Hetman,
Alok Kumar
Publication year - 2021
Publication title -
hca healthcare journal of medicine
Language(s) - English
Resource type - Journals
eISSN - 2690-3830
pISSN - 2689-0216
DOI - 10.36518/2689-0216.1191
Subject(s) - mucormycosis , medicine , amphotericin b , surgery , debridement (dental) , colostomy , antifungal , dermatology
Description Mucormycosis is a rare devastating fungal infection with a high mortality rate often associated with diabetic and immunosuppressed individuals. However, infections found in postoperative states and in immunocompetent patients are rare. Systemic liposomal amphotericin is viewed as a first line treatment for mucormycosis in addition to aggressive debridement to prevent the spread of infection. Literature describing the treatment of mucormycosis with both systemic and topical amphotericin B is scarce. We present a case of an immunocompetent male admitted for perforated diverticulitis who received a left hemicolectomy with colostomy creation. During hospitalization, stool from the colostomy bag was reportedly leaking into the wound. The patient was found to have extensive necrotic tissue with mold growing in his postoperative incision site. The wound culture and pathology report confirmed mucormycosis. The patient was treated with intravenous (IV) liposomal amphotericin B, wound dressings with an amphotericin/saline mixture twice daily and serial wound debridements. The patient was discharged in stable condition with successful wound healing.