Post-traumatic soft tissue infection due to Absidia corymbifera

Purpose. Zygomycotic infections of traumatic wounds are rare in immunocompe tent subjects. When these infections occur, they seldom involve Absidia cor ymbifera which, dispite being ubiquitous in nature, is not usually harmful to man. Firm guidelines are still lacking for the treatment of these cases, as no current therapeutic option offers clear-cut advantages. We report he rein on one such case, which was successfully treated using surgery, only. Patient. A 22-year-old, immunocompetent man from Molise (Italy) suffered mu ltiple exposed bone fractures of both legs in a car crash. He developed acu te renal failure due to crash syndrome as well as bilateral bronchopneumoni c involvement causing acute respiratory failure. After 10 days of hospitali zation, a mycelial mass was evident at the distal, lateral side of both leg s, where vast patches of necrotic tissue were present. A. corymbifera was i solated from all clinical samples. In light of this diagnosis, widespread b ut accurate surgical resection of necrotized tissue was carried out. Eighte en months after surgery the patient showed full recovery of soft tissue int egrity together with satisfactory functional recovery. Discussion. Our observation provides further evidence that wounds contamina ted with ground debris following car accidents may cause opportunistic fung al complications due to zygomycetes, which in our immunocompetent patient w as caused by A. corymbifera. Our successful therapeutic approach, based on prompt and wide surgical debridement of infected tissues, corroborates the key role of surgery in these cases.