Auricular Mucormycosis Following Burn Injury: A Case Report with Literature Review

Abstract

Objective: Mucormycosis is a dreaded clinical entity caused by filamentous fungi of the order Mucorales. Traumatic mucormycosis mainly occurs in civilian trauma, burns and vehicle accidents. Herein, we present a rare case of burn-related mucormycosis in a 29-year-old healthy male patient. Methods: The patient was referred to our hospital after being involved in a car accident with vehicle explosion and burn injury. 20 days after admission to our hospital, a new discharge from the left ear was noticed. Microbiological results revealed high suspicion of fungal infection and pathologic examination of necrotic cartilage revealed aseptate hyphae of mucormycosis Results: A prompt parenteral liposomal Amphotericin B was initiated, local control of the disease by extensive surgical debridement was performed, including total excision of both auricles and cartilaginous parts of the external auditory canals. Excisions were done until a healthy, bleeding tissue was obtained. The wounds healed completely without any recurrence Conclusions: Mucormycotic infections are uncommon in patients with burns; however, when they are present, they usually occur as a cutaneous burn wound infection and remain difficult to treat and is often lethal. This necessitates prompt and early diagnosis, control of risk factors, surgical debridement of necrosed tissue and antifungal drugs. Amphotericin B is the antifungal of choice for the treatment of mucormycosis. Since inoculation of soil-dwelling moulds into wounds can occur at the time of injury, the context in which burns occur needs to be considered to evaluate the risk of mucormycosis, especially in auricles which are likely at increased risk, probably because they protrude from the head and come more in contact with the ground.