Xiaoqing Huang,1 Junke Qiu,1 Lei Pan,1 Caihong Wang,1 Chuanfeng Tang2 

1Tuberculosis Intensive Care Unit, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2Emergency Department, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, Zhejiang, Peoples Republic of China

Correspondence: Chuanfeng Tang, Emergency Department, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, No. 208 East Huancheng Road, Hangzhou, Zhejiang, 310000, People’s Republic of China, Tel +8615155110013, Email T20237243@163.com

Background: Zygomycosis, also termed mucormycosis, is a rare yet highly fatal fungal infection caused by Mucorales species, notably Rhizopus spp.
Case Presentation: This case study details a 72-year-old man with diabetes, pulmonary tuberculosis, and nephrotic syndrome who developed acute necrotizing fasciitis attributable to R. oryzae. Despite initial empirical antibiotic therapy, the infection progressed rapidly. Metagenomic next-generation sequencing (mNGS) facilitated a swift diagnosis, identifying R. oryzae in blood and drainage samples. The treatment included amphotericin B and isavuconazole, along with aggressive surgical debridement. The patient exhibited substantial improvement, and he was discharged after stabilization.
Conclusion: This case highlights the critical role of early diagnosis through mNGS and the need for a multidisciplinary approach to manage severe mucormycosis in immunocompromised patients.

Keywords: Rhizopus infection, acute necrotizing fasciitis, diabetes, case report