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Lower-Extremity Zygomycosis in a Patient with Traumatic InjuriesA Case Report
Ryan C. Koonce, MD1; Connie S. Price, MD1; Deanna A. Sutton2; Brian L. Wickes, PhD2; Paul N. Montero, MD1; Steven J. Morgan, MD1
1 Department of Orthopaedic Surgery (R.C.K. and S.J.M.), Division of Infectious Diseases, Department of Medicine (C.S.P.), and Department of Surgery (P.N.M.), Denver Health Medical Center and University of Colorado School of Medicine, 777 Bannock Street, Denver, CO 80204. E-mail address for R.C. Koonce: ryan.koonce@uchsc.edu
2 Departments of Pathology and Microbiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Investigation performed at Denver Health Medical Center, Denver, Colorado

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Mar 01;91(3):686-692. doi: 10.2106/JBJS.H.00187
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Zygomycosis, also called mucormycosis, is an aggressive fungal infection found rarely in patients who have sustained traumatic injuries. Traumatic contact with an extremity may introduce the fungi through the mucocutaneous barrier, and progression of the infection can be fatal if vascular invasion, tissue infarction, and necrosis occur. Zygomycosis is usually found in immunocompromised individuals, but trauma may introduce and potentiate infection in patients without preexisting risk factors1-3. Although it is a rare complication of trauma, identification of the infection is important because the overall mortality rate from documented cutaneous zygomycosis inoculation has been reported to be as high as 31%4. Successful treatment depends primarily on early diagnosis and surgical débridement and secondarily on administration of appropriate antifungal medications.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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