case_images: PMC11784252_01
case_images: Clinical and histopathological progression of appendiceal perforation and abdominal wall infection caused by invasive mucormycosis in a child with acute leukemia. a. Histopathological appendix: Significant localized hemorrhage and necrosis of the appendix, with scattered infiltration of lymphocytes and neutrophils. Abundant hyphae present throughout the entire wall and within the blood vessels, PAS(+). b. Postoperative wound at the site of right abdominal puncture measuring approximately 4x1 cm, with blackened tissue and surrounding erythema measuring about 8x9 cm. c. Progression of right abdominal wall infection, characterized by the discharge of yellow-green feculent material, raising the suspicion of an enterocutaneous fistula. d. Worsening of the right abdominal wound infection with necrosis of the skin and subcutaneous tissue, exposing the ribs and penetrating the abdominal muscle layer, with visible liver tissue and fistula leakage. The arrow indicates the exposed rib. e. Postoperative image showing the colostomy bag following vacuum sealing drainage and enterostomy. f. Healing of the infection site, with granulation tissue formation visible.
case_images: IDR-18-495-g0001.jpg
case_images: PMC11784252_01_IDR-18-495-g0001.jpg
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case_images: Histopathological examination of the appendix confirmed mucormycosis infection with necrosis and perforation (Figure 1a). Physical examination revealed a blackened area (4x1 cm) at the site of puncture drainage in the right abdomen, with surrounding skin redness (8x9 cm) (Figure 1b). Over time, the right abdominal wall infection worsened (Figure 1c), with yellow-green fecal-like discharge, raising concerns about an enterocutaneous fistula. Necrosis of the skin and subcutaneous tissues extended to the fascia, exposing ribs and hepatic tissue, with leakage of fistula fluid (Figure 1d). The patient was transferred to an external hospital for vacuum sealing drainage and enterostomy (Figure 1e), followed by treatment with liposomal amphotericin B for mucormycosis. The infection was successfully controlled, and the wound gradually healed, and the patient was eventually discharged in an improved condition (Figure 1f).