Subcutaneous entomophthoromycosis mimicking soft-tissue sarcoma in children

Journal of Pediatric Surgery
Venkatachalam RaveenthiranViswanathan Anandi

Abstract

Subcutaneous entomophthoromycosis (EM) is an uncommon fungal infection of childhood. This article is intended to draw the attention of pediatric surgeons to the fact that EM can mimic soft-tissue tumor. It is a retrospective review of 16 children treated for subcutaneous EM between 2000 and 2013. The median age of patients was 3.5 years. The typical lesion was a discoid subcutaneous mass that can be easily lifted from deeper tissues (the doughnut lifting sign). Lesions were mostly distributed in the lower half of body. All the patients were immunocompetent. Correct clinical diagnosis was made only in 4 cases while others were mistaken for a tumor. All the 8 children who underwent wide excision of the pseudotumor had local recurrence. Supersaturated solution of potassium iodide was curative in 11 cases while addition of itraconazole was needed in one case. One child died of multi-drug resistant infection. The mean treatment duration was 4.7 months (range 2-8 months). Subcutaneous EM can mimic soft-tissue tumor. High index of suspicion is essential to avoid misdiagnosis and inappropriate treatment. A newly described "doughnut-lifting sign' may be helpful in clinical diagnosis. Emergence of multi-drug resistant infection is a sour...Continue Reading

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Citations

Apr 26, 2016·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·N ShaikhT J Walsh
Jan 15, 2019·Dermatologic Therapy·Divya KamatKeshavamurthy Vinay
Aug 31, 2018·Clinical Microbiology Reviews·Raquel Vilela, Leonel Mendoza
Jun 10, 2017·Microbiology Spectrum·Julia R KöhlerJohn R Perfect
Jun 22, 2021·International Journal of Dermatology·Bushra MunaKrishnakanth Muralidhar
Nov 7, 2020·Indian Journal of Pathology & Microbiology·Lalit TakiaSushil K Kabra

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