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Case report
Primary cutaneous mucormycosis of the abdomen at the site of repeated insulin injections
  1. Allison Perz1,
  2. Gabriel Makar1,
  3. Edward Fernandez2,
  4. Joshua Weinstock3 and
  5. William Rafferty4
  1. 1Rowan University Cooper Medical School, Camden, New Jersey, USA
  2. 2Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  3. 3Internal Medicine, Cooper University Hospital, Camden, New Jersey, USA
  4. 4Department of Pathology, Cooper University Hospital, Camden, New Jersey, USA
  1. Correspondence to Allison Perz; perza2{at}rowan.edu

Abstract

A 71-year-old woman with metastatic squamous cell carcinoma of the lung and insulin-dependent type 2 diabetes mellitus presented with a necrotic lesion on her lower abdomen. Further history revealed that this was the site of repeat insulin injections with reuse of the same needles. On investigation, biopsy of the site was positive for broad, aseptate, right-angle branching fungal hyphae consistent with mucormycosis. Studies have shown that insulin needle reuse is a common practice among diabetics for several reasons, including cost and convenience. While the current American Diabetes Association guidelines suggest that this is an acceptable practice among the general population of diabetics, they advise against it in patients who are actively ill or immunocompromised. Discussion about insulin needle reuse should be of utmost importance among providers and their diabetic patients, especially for patients who are immunocompromised.

  • dermatology
  • infections
  • diabetes
  • infectious diseases
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Footnotes

  • Contributors AP: conception, planning, analysis and data interpretation, manuscript drafting and editing, final draft approval. GM: conception, planning, analysis and data interpretation, manuscript drafting and editing, final draft approval. EF: conception, planning, analysis and data interpretation, manuscript drafting and editing, final draft approval. JW: conception, planning, acquisition of data, analysis and data interpretation, manuscript editing, final draft approval. WR: conception, planning, acquisition of data, analysis and data interpretation, manuscript editing, final draft approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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