title: Cutaneous zygomycosis in a diabetic HTLV-I-seropositive man.
abstract: Zygomycosis, an invasive fungal infection, is usually seen in persons with diabetes, particularly in those with diabetic ketoacidosis. The infection most frequently occurs in the rhinocerebral region and rapidly spreads, causing a swift demise. Rarely, the infection is confined to the cutaneous tissues. We describe a 31-year-old man seropositive for human T lymphotropic virus type I who had diabetic ketoacidosis with zygomycosis confined to the right arm. The lesion was presumed initially to be a bacterial infection but did not respond to conventional antimicrobial therapy. The arm lesion was cultured, and Rhizopus arrhizus was isolated. The patient responded well to a combination of amphotericin B and extensive surgical debridements. Our case emphasizes the importance of maintaining a high index of suspicion of cutaneous zygomycotic infections in the impaired host, especially of those in patients with diabetes, who do not respond to initial antimicrobial treatment.
authors.affiliation: Section of Infectious Disease, Tulane University, New Orleans, LA.
authors.forename: R
authors.initials: R
authors.lastname: Clark
authors.forename: D L
authors.initials: DL
authors.lastname: Greer
authors.forename: T
authors.initials: T
authors.lastname: Carlisle
authors.forename: B
authors.initials: B
authors.lastname: Carroll
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D015490:HTLV-I Infections / Q000150:complications*; D006801:Humans; D008297:Male; D009091:Mucormycosis / Q000150:complications* / Q000473:pathology / Q000628:therapy; D009336:Necrosis; D012233:Rhizopus; D012867:Skin / Q000473:pathology