Fatal Cutaneous Mucormycosis Initially Misdiagnosed as Necrotizing Fasciitis in an Uncontrolled Diabetic Patient: A Case Report Highlighting Diagnostic Delay.
Yovita Hartantri, Stephanie Victoria Gunadi, Ferdy Ferdian et al.
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Case in brief
A 64-year-old male with undiagnosed diabetes presented with altered consciousness and extensive necrotic lesions, initially diagnosed as bacterial necrotizing fasciitis. Despite broad-spectrum antibiotics and surgical debridement, a false-negative KOH smear delayed the diagnosis of mucormycosis, which was confirmed only after culture. The patient deteriorated and died on day twelve of hospitalization, highlighting the critical need for timely diagnosis.
Diagnostic / clinical pearl
Clinicians should maintain a high suspicion for mucormycosis in diabetic patients with rapidly progressive necrotic infections, even when initial fungal tests are negative.
Why it matters
This case underscores the importance of considering invasive fungal infections in the differential diagnosis of necrotizing soft tissue infections, particularly in patients with uncontrolled diabetes.