A particularly important cause of invasive infection is the application of Elastoplast tape to surgical wounds or I.V. sites. Whatever the initial form of skin injury, the invasion of Mucoraceae organisms causes striking skin abnormalities that range from frank infarction with a black eschar to ecthyma gangrenosum-like abnormalities. Hematogenous dissemination can occur from these sites, and it is essential that diagnostic biopsy be performed early for the patient to survive. The only reliable method of diagnosing mucormycosis is biopsy to demonstrate the presence of organisms. Immunodiagnosis and routine culture methods are of no value in diagnosing this disorder.
Survival requires early diagnosis and therapy.
Amphotericin B is the only agent effective against Mucoraceae infection, although questions about resistance have been raised. Even at such dosages, antifungal therapy must be regarded as ancillary to surgical removal of the infected tissue. The primary therapy is radical surgery akin to that performed for cancer. Because mutilating surgery may be required, diagnosis of mucormycosis at an early stage is critical.