Undiagnosed mucormycosis in infants.
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An 18-year-old woman (a former intravenous drug abuser) sustained open tibial plateau and shaft fractures, followed by cellulitis and a wound infection caused by a Rhizopus species, which is a fungus of the class Mucorales. The patient responded to surgical debridement and a prolonged course of amphotericin B. No lymphocyte abnormality or other host immune defect could be demonstrated in this patient.
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Increased susceptibility to Rhizopus oryzae in diabetes was investigated using mice in which diabetic ketoacidosis was experimentally induced. All of the diabetic mice which had developed ketoacidosis died within four days after inoculation of R. oryzae and their serum UIBCs (Unbound iron binding capacity) were significantly lower than those of the normal control mice. This study suggested that the decreased serum UIBC produced by diabetic ketoacidosis enhances the growth of R. oryzae in vivo.