Life-saving hip disarticulation following necrotizing myofasciitis from invasive mucormycosis after blast injury: A case report.

introductionNecrotizing myofasciitis is a rapidly progressing, life-threatening infection involving deep soft tissues, often caused by bacterial pathogens. However, fungal etiologies such as invasive mucormycosis, particularly in trauma patients, are rare and associated with high morbidity. Blast injuries create hypoxic environments conducive to fungal proliferation, complicating clinical management and often necessitating aggressive surgical interventions such as amputation. PRESENTATION OF CASE: We present the case of a 26-year-old male with no prior medical history, who sustained multiple injuries from a bomb blast. The patient developed necrotizing myofasciitis secondary to invasive mucormycosis (Rhizopus species) and Streptococcus pyogenes. Despite repeated debridements and initiation of antifungal therapy with liposomal amphotericin B, the infection progressed rapidly. Acute kidney injury, severe sepsis, and extensive tissue necrosis prompted life-saving hip disarticulation. Postoperatively, the patient stabilized and transitioned to rehabilitation with a multidisciplinary care approach. DISCUSSION: This case highlights the challenges of managing necrotizing myofasciitis caused by mucormycosis after blast trauma. Tissue ischemia favored fungal growth, with Rhizopus and Streptococcus pyogenes identified as pathogens. Liposomal amphotericin B and a multidisciplinary approach were critical in managing systemic complications, including sepsis and acute kidney injury.

conclusionInvasive mucormycosis following trauma is a rare but devastating condition requiring early recognition, and a combination of aggressive surgical and medical management. This case highlights the critical role of hip disarticulation as a life-saving measure in refractory necrotizing infections, emphasizing the importance of a multidisciplinary approach to optimize outcomes in complex clinical scenarios.