24 October 2025
: Case report 
Management and Surgical Dressing Protocol for Cutaneous Mucormycosis After a Blast Injury: A Case Report
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Abdulaziz M. Tawffeq ABEF 1*, Talal A. Almutairi
ABEF 1, Rema F. Alrashed ABEF 1, Ayed I. Almutairi ABDEF 1, Nagoud M. Ali ABEF 2
DOI: 10.12659/AJCR.949392
Am J Case Rep 2025; 26:e949392
Table 1 Clinical timeline and treatment progression.
| Time | Clinical events | Interventions/notes |
|---|---|---|
| Day 0 (injury) | Sustained blast injury; body covered in soil; transferred after 3 days | Initial injury |
| Day 3 (admission) | Arrival at tertiary center; tachycardic; diffuse pain, multiple wounds and shrapnel with traumatic amputation | Initial assessment and stabilization |
| Days 4–12 | Underwent 3 intraoperative debridements and dressing changes as per a personally developed protocol | Progressive wound care assessment and management |
| Day 9 | Developed chills, rigors, night sweats | Antibiotics escalated from ceftazidime to piperacillin-tazobactam |
| Day 10–11 | Symptoms worsened, recurring every 3 hours | Close monitoring; continued same antimicrobial and symptomatic management |
| Day 12 | 4t debridement session: worsening wounds with necrosis and slough; serous/whitish discharge from the amputation site | Suspicion of mucormycosis raised; multiple tissue biopsies sent for culture and histopathology, and empirical IV liposomal amphotericin B (255 mg daily) initiated |
| Day 14–15 | After 2 doses of amphotericin B, systemic symptoms resolved, 5 debridement session, significant wound healing observed | Decision to continue amphotericin despite no initial microbiological confirmation |
| Day 29 | Histopathology confirmed mucormycosis; cultures remained negative | Diagnosis confirmed retrospectively |
| Day 44 | Completed 32 days of amphotericin B and 11 debridement sessions | Wounds fully healed; stump clean and ready for prosthetics |
| After discharge and 6-month follow-up | Referred to prosthetic rehabilitation program and Completed therapy successfully | Patient living independently with prosthesis; attending social events, and with good functional recovery |