title: [Cutaneous mucormycosis caused by Rhizopus microsporus].
abstract: BACKGROUND
  Mucormycosis are rare fungal infections occurring chiefly in the lung or the rhinocerebral compartment, particularly in patients with immunodeficiency or mellitus diabetes. We report the case of an elderly patient with cutaneous mucormycosis caused by Rhizopus microsporus.
  
  
  METHODS
  An 89-year-old man presented a skin lesion of the forearm rapidly becoming inflammatory and necrotic. The patient had been treated for 2months with oral corticosteroids for idiopathic thrombocytopenia. Histological and mycological examination of the skin biopsy revealed the presence of a filamentous fungus, R. microsporus. The outcome was unfavorable, despite prescription of high-dose liposomal amphotericin B.
  
  
  CONCLUSIONS
  Mucormycosis are infrequent opportunistic infections caused by angio-invasive fungi belonging to the Mucorales order. Cutaneous presentations are rare, and in rare cases the species R. microsporus is isolated in clinical samples. Diagnosis is based on histological examination highlighting the characteristic mycelium within infected tissue, together with ex vivo mycological identification using morphological and molecular methods. Treatment consists of liposomal amphotericin B combined with debridement surgery.
  
  
  CONCLUSIONS
  R. microsporus is a marginal fungal species rarely isolated in clinical practice, and even less in dermatology departments. This clinical case report highlights the severity of infection with this fungus, particularly in the absence of early surgery.
authors.affiliation: Service de parasitologie - mycologie - médecine tropicale, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 09, France; CEPR, Inserm U1100, EA 6305, faculté de médecine, université François-Rabelais, 10, boulevard Tonnellé, BP 3223, 37032 Tours, France. Electronic address: guillaume.desoubeaux@univ-tours.fr.
authors.forename: G
authors.initials: G
authors.lastname: Desoubeaux
authors.affiliation: Service de parasitologie - mycologie - médecine tropicale, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 09, France.
authors.forename: M
authors.initials: M
authors.lastname: Leperlier
authors.affiliation: Service de médecine interne et maladies infectieuses, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 09, France.
authors.forename: H
authors.initials: H
authors.lastname: Chaussade
authors.affiliation: Service de médecine interne et maladies infectieuses, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 09, France.
authors.forename: C
authors.initials: C
authors.lastname: Schneider
authors.affiliation: Service de dermatologie, CHU de Tours, avenue de la République, 37170 Tours cedex 09, France.
authors.forename: M
authors.initials: M
authors.lastname: Roriz
authors.affiliation: Service de parasitologie - mycologie - médecine tropicale, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 09, France.
authors.forename: C
authors.initials: C
authors.lastname: Houssin
authors.affiliation: Service d'anatomie et cytologie pathologiques, CHU de Tours, avenue de la République, 37170 Tours cedex 09, France.
authors.forename: C
authors.initials: C
authors.lastname: Rogez
authors.affiliation: Service d'anatomie et cytologie pathologiques, CHU de Tours, avenue de la République, 37170 Tours cedex 09, France.
authors.forename: A
authors.initials: A
authors.lastname: De Muret
authors.affiliation: Centre national de référence des mycoses invasives et antifongiques, Institut Pasteur, 25-28, rue du Docteur-Roux, 75015 Paris, France; CNRS URA3012, Institut Pasteur, 25, rue du Docteur-Roux, 75724 Paris cedex 15, France.
authors.forename: D
authors.initials: D
authors.lastname: García-Hermoso
authors.affiliation: Service de parasitologie - mycologie - médecine tropicale, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 09, France.
authors.forename: É
authors.initials: É
authors.lastname: Bailly
authors.affiliation: Service de dermatologie, CHU de Tours, avenue de la République, 37170 Tours cedex 09, France.
authors.forename: É
authors.initials: É
authors.lastname: Le Fourn
authors.affiliation: Service de dermatologie, CHU de Tours, avenue de la République, 37170 Tours cedex 09, France; Inserm U930, faculté de médecine, université François-Rabelais, 2, boulevard Tonnellé, 37044 Tours cedex 09, France.
authors.forename: L
authors.initials: L
authors.lastname: Machet
authors.affiliation: Service de parasitologie - mycologie - médecine tropicale, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 09, France; CEPR, Inserm U1100, EA 6305, faculté de médecine, université François-Rabelais, 10, boulevard Tonnellé, BP 3223, 37032 Tours, France.
authors.forename: J
authors.initials: J
authors.lastname: Chandenier
authors.affiliation: CEPR, Inserm U1100, EA 6305, faculté de médecine, université François-Rabelais, 10, boulevard Tonnellé, BP 3223, 37032 Tours, France; Service de médecine interne et maladies infectieuses, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 09, France.
authors.forename: L
authors.initials: L
authors.lastname: Bernard
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000008:administration & dosage; D001706:Biopsy; D003881:Dermatomycoses / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D009091:Mucormycosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D009336:Necrosis; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D010166:Palliative Care; D012233:Rhizopus / Q000648:ultrastructure; D012867:Skin / Q000473:pathology; D013921:Thrombocytopenia / Q000188:drug therapy
chemical_list: D000305:Adrenal Cortex Hormones; C068538:liposomal amphotericin B; D000666:Amphotericin B
keywords: Amphotéricine B liposomale; Chirurgie; Corticosteroids; Corticoïdes; Cutaneous mucormycosis; Debridement surgery; Liposomal amphotericin B; Mucormycose cutanée; Rhizopus microsporus