{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T22:03:40Z","timestamp":1773698620410,"version":"3.50.1"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2022,3,7]],"date-time":"2022-03-07T00:00:00Z","timestamp":1646611200000},"content-version":"vor","delay-in-days":371,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T00:00:00Z","timestamp":1614816000000},"content-version":"tdm","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-aps.org"],"crossmark-restriction":true},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>Mucormycosis is an invasive, rapidly progressive, life-threatening fungal infection, with a propensity for diabetic, immunosuppressed, and trauma patients. The classic rhinocerebral variation is most common in diabetic patients. While the cutaneous form is usually caused by direct inoculation in immunocompetent patients. Cutaneous mucormycosis manifests in soft tissue and risks involvement of underlying structures. Tibial osteomyelitis can also occur secondary to cutaneous mucormycosis but is rare. Limb salvage is typically successful after lower extremity cutaneous mucormycosis even when the bone is involved. Herein, we report two cases of lower extremity cutaneous mucormycosis in diabetic patients that presented as acute worsening of chronic pretibial ulcers. Despite aggressive antifungal therapy and surgical debridement, both ultimately required amputation. Such aggressive presentation has not been reported in the absence of major penetrating trauma, recent surgery, or burns.<\/jats:p>","DOI":"10.5999\/aps.2020.00549","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T07:20:19Z","timestamp":1614842419000},"page":"231-236","update-policy":"https:\/\/doi.org\/10.5999\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cutaneous mucormycosis of the lower extremity leading amputation in two diabetic patients"],"prefix":"10.1055","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0631-9779","authenticated-orcid":false,"given":"Kathleen M.","family":"Coerdt","sequence":"additional","affiliation":[{"name":"Georgetown University School of Medicine, Washington, D.C. USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6271-6918","authenticated-orcid":false,"given":"Elizabeth G.","family":"Zolper","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9894-4058","authenticated-orcid":false,"given":"Amy G.","family":"Starr","sequence":"additional","affiliation":[{"name":"Department of Pathology, MedStar Georgetown University Hospital, Washington, D.C., USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5951-5576","authenticated-orcid":false,"given":"Kenneth L.","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7114-6275","authenticated-orcid":false,"given":"Christopher E.","family":"Attinger","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1056-2114","authenticated-orcid":false,"given":"Karen K.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C., USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,3,7]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"3862","DOI":"10.1128\/JCM.02094-08","article-title":"Molecular and phenotypic evaluation of Lichtheimia corymbifera (formerly Absidia corymbifera) complex isolates associated with human mucormycosis: rehabilitation of L. ramosa","volume":"47","author":"D Garcia-Hermoso","year":"2009","journal-title":"J Clin Microbiol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1128\/CMR.18.3.556-569.2005","article-title":"Novel perspectives on mucormycosis: pathophysiology, presentation, and management","volume":"18","author":"B Spellberg","year":"2005","journal-title":"Clin Microbiol Rev"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1093\/cid\/cir866","article-title":"Epidemiology and clinical manifestations of mucormycosis","volume":"54 Suppl 1","author":"G Petrikkos","year":"2012","journal-title":"Clin Infect Dis"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"26","DOI":"10.3390\/jof5010026","article-title":"Global epidemiology of mucormycosis","volume":"5","author":"H Prakash","year":"2019","journal-title":"J Fungi (Basel)"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/0895-4356(94)90129-5","article-title":"Validation of a combined comorbidity index","volume":"47","author":"M Charlson","year":"1994","journal-title":"J Clin Epidemiol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1128\/CMR.00053-10","article-title":"Histopathologic diagnosis of fungal infections in the 21st century","volume":"24","author":"J Guarner","year":"2011","journal-title":"Clin Microbiol Rev"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.cmi.2018.07.011","article-title":"The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports","volume":"25","author":"W Jeong","year":"2019","journal-title":"Clin Microbiol Infect"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"e582","DOI":"10.1097\/BCR.0000000000000430","article-title":"Burn wound mucormycosis: a case study on poor wound healing","volume":"38","author":"B Stanistreet","year":"2017","journal-title":"J Burn Care Res"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/00003086-200012000-00026","article-title":"Mucormycosis of the tibia: a case report and review of the literature","volume":"(381)","author":"PD Holtom","year":"2000","journal-title":"Clin Orthop Relat Res"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1128\/jcm.25.5.933-935.1987","article-title":"Saksenaea vasiformis osteomyelitis","volume":"25","author":"PF Pierce","year":"1987","journal-title":"J Clin Microbiol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1093\/mmy\/myx101","article-title":"Challenges in the diagnosis and treatment of mucormycosis","volume":"56","author":"A Skiada","year":"2018","journal-title":"Med Mycol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1097\/00000372-198410000-00011","article-title":"Osteomyelitis secondary to cutaneous mucormycosis: report of a case and a review of the literature","volume":"6","author":"N Maliwan","year":"1984","journal-title":"Am J Dermatopathol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s11046-015-9943-9","article-title":"Early diagnosis of cutaneous mucormycosis due to Lichtheimia corymbifera after a traffic accident","volume":"181","author":"T Tyll","year":"2016","journal-title":"Mycopathologia"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"e00653","DOI":"10.1128\/AAC.00653-19","article-title":"A revised species concept for opportunistic Mucor species reveals species-specific antifungal susceptibility profiles","volume":"63","author":"L Wagner","year":"2019","journal-title":"Antimicrob Agents Chemother"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"4428","DOI":"10.1128\/JCM.02138-14","article-title":"Primary cutaneous mucormycosis produced by the new species Apophysomyces mexicanus","volume":"52","author":"A Bonifaz","year":"2014","journal-title":"J Clin Microbiol"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-aps.org\/upload\/pdf\/aps-2020-00549.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-aps.org\/journal\/view.php?doi=10.5999\/aps.2020.00549","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.5999\/aps.2020.00549.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T16:06:04Z","timestamp":1730822764000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.5999\/aps.2020.00549"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":15,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2022,3,7]]},"published-print":{"date-parts":[[2021,3]]}},"URL":"https:\/\/doi.org\/10.5999\/aps.2020.00549","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"value":"2234-6163","type":"print"},{"value":"2234-6171","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]},"assertion":[{"value":"2020-03-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-04","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-15","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}