Case #14:

Clinical Presentation:
Case 14 Image 1 shows a debrided hematoma a 22-year-old Leukemia patient. Greyish-brown fringes of "bread-mold-like" filaments arising from necrotic muscle were noted.

Clinical Diagnoses:
Non-resolving Hematoma (Case 14 Image 4)

Case 14 Image 2 is direct microscopic of tissue specimens showing broad, non-septate branched hypae.
Case 14 Image 3 is histologic section of debrided tissue from hematoma showing numerous, ribbon-like, non-septate hyphae.

Discussion:
Microbiologic Diagnosis:
Invasive Mucormycosis (Rhizopus species)
This opportunistic mycosis can contaminate wounds in immunocompromised patients. Extensive debridement and antifungal therapy did not prevent dissemination to the lung. Mucormycosis can also present in a rhinocerebral form (Case 14 Image 4) following spore inhalation and germination. This has occurred in Diabetics and other immunocompromised persons.