Cutaneous Mucormycosis Following Polytrauma: A Multidisciplinary Approach

Cutaneous mucormycosis is a rare but aggressive fungal infection, increasingly reported in trauma patients without traditional immunosuppressive risk factors. We report the case of a 22-year-old male who developed cutaneous mucormycosis following severe polytrauma from a motorbike-truck collision, presenting with a perineal degloving wound, bilateral testicular avulsion, urethral transection, and subtrochanteric femur fracture. He was resuscitated for hemorrhagic shock and underwent diversion colostomy, suprapubic catheterization, and serial debridement. Persistent necrosis despite antibiotics and negative-pressure wound therapy (NPWT) prompted fungal evaluation, confirming mucormycosis. Intravenous liposomal amphotericin B (5 mg/kg/day) with continued debridement controlled the infection, after which NPWT was reinitiated to optimize the wound bed. Definitive management included split-thickness skin grafting and femoral nailing, alongside testosterone replacement. Antifungal therapy transitioned to oral posaconazole after three weeks of amphotericin B. This case emphasizes early suspicion of mucormycosis in non-healing contaminated wounds, timely antifungal therapy, and staged multidisciplinary management, including cautious NPWT use, to achieve favorable outcomes.