Utilidad de la biopsia por congelación para el diagnóstico y tratamiento de la mucormicosis. Reporte de un caso y revisión de la literatura

Abstract

Background: Mucormycosis refers to fungal infections of the Mucoraceae family, of the order Mucorales. There are 3 important genera responsible for human infections: Rhizopus, Mucor and Absidia. Mucormycosis May be, rhinocerebral, sinonasal, pulmonary, gastrointestinal, cutaneous and disseminated have been described. Usually affects immunocompromised patient or with some degree of immune system compromise. \nCase report: 24-year-old female patient with approximately one month of evolution of left otalgia who received different antibiotic management without improvement of the condition. She refers that she had a procedure on the upper left dental face and arch with subsequent change in skin color, paleness and necrosis. A diagnosis of soft tissue sepsis and diabetes mellitus de novo is made. It is evaluated by the dermatology service who take biopsy for frozen sections, in which hyaline filaments in the form of ribbons, hyphae with irregular walls and variable diameter, some irregularly branched, at angles greater than 45° and few septa are recognized, which stand out with the periodic acid Schiff (PAS) staining in the subsequent paraffin sections. The objective of this article is to describe the usefulness of frozen biopsy in the early diagnosis of mucormycosis. \nConclusions: The use of frozen section biopsy in the context of mucormycosis has proven to be a valuable tool for intraoperative evaluation of skin and soft tissues with great impacts in the evaluation of treatment and survival, so it must be controlled in conjunction with clinical characteristics at the time of decision making.