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Clinical Note |

Facial Cutaneous Mucormycosis in a Full-term Infant

Sandeep P. Dave, MD; Richard J. Vivero, AB; Soham Roy, MD, FAAP
Arch Otolaryngol Head Neck Surg. 2008;134(2):206-209. doi:10.1001/archoto.2007.48.
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ABSTRACT

Mucormycosis is a rare and potentially fatal fungal infection that most commonly affects the immunocompromised population. Although originally described by Paltauf in 1885 (D. G. Finn as cited by Vessely et al1(p573) and A. M. Marchevsky as cited by Oh and Notrica2(p1607)), it was not until 1955 that Harris (as cited by Vessely et al1(p573)) reported the first case of a mucormycosis survivor. In recent years, the number of immunosuppressed patients has increased partly owing to the widespread implementation of organ transplantation and the increasing prevalence of human immunodeficiency virus infection. Consequently, the incidence of mucormycosis has also increased, especially in pediatric patients. In the setting of immunocompromise, a high index of suspicion is required to accurately diagnose and treat this potentially lethal infection in a timely fashion. To our knowledge, we report the first case of facial cutaneous mucormycosis in an infant, who also represents the first reported neonate or infant to survive a cutaneous mucormycosis infection of the head and neck.

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Figure 1.

Fungal hyphae (Gomori methenamine silver, original magnification ×400).

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Figure 2.

Views of facial cutaneous mucormycosis in a full-term, 6-month-old, female infant. A, Preoperative view shows a clearly demarcated area of necrosis and skin breakdown involving the left cheek. B, Intraoperative view demonstrates debridement to the level of the buccal fat pad with evidence of underlying healthy bleeding tissue.

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Figure 3.

Postoperative view of the same patient at 9 weeks after split-thickness skin graft to the left cheek.

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