Successful Salvage of Mucormycosis Infection of the Forearm and Osteomyelitis of the Ulna

Abstract

A 6-month-old child developed cutaneous mucormycosis of the forearm 5 weeks after liver transplantation, which progressed to osteomyelitis of the proximal ulna. Aggressive treatment, which included serial radical debridements, intravenous administration of amphotericin B, and eventually split thickness skin graft coverage resulted in successful functional salvage of the forearm, wrist, and hand. Of the nine previously reported cases of mucormycosis affecting the forearm or hand in immunocompromised patients, all either required amputation of the hand or below elbow amputation, or resulted in the patient's death. Definitive early diagnosis and serial radical debridements may allow salvage of a functional hand.