CUTANEOUS MUCORMYCOSIS AROUND PERITONIAL DIALYSIS SITE-CASE REPORT

Mucormycosis is an aggressive fungal infection caused by Zygomycetes, affecting the immunocompromised. It is associated with long term morbidity and fatality, if not diagnosed and treated early. We report a case of cutaneous mucormycosis in a diabetic patient on peritoneal dialysis near the catheter, under the surgical dressing.48 years old lady on peritoneal dialysis presented with pain, redness and induration of skin over the abdomen near the catheter of one week duration. The lesions progressed to form necrotic areas in 2 days. Investigations revealed ANA positivity, elevated ferritin, parathyroid hormone, potassium and phosphorus levels. Differential diagnosis of calciphylaxis was considered. Histopathology showed broad aseptate hyphae morphologically similar to mucormycosis. She was treated with Amphotericin B and improved. Immunocompromised patients with disruption of the normal protective barrier are at risk of developing cutaneous mucomycosis. The portal of entry in such patients are injection sites, catheter insertion sites, under surgical dressings and penetrating injury.Cutaneous mucormycosis starts as cellulitis then becomes necrotic and results in eschar formation, as it did in our patient. The diagnosis was based on clinical findings and histopathology was confirmatory. Early detection and prompt treatment can prevent fatality as in our case.