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A Nontraumatic Surprise Neck Mass

  1. Gerald Capraro3
  1. 1Internal Medicine
  2. 2Infectious Disease, Carolinas Medical Center
  3. 3Clinical Microbiology Laboratory, Carolinas Healthcare System, Charlotte, North Carolina
  1. Anthony Amoroso, Section Editor
  1. Correspondence: A. Simmelink, Internal Medicine, Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC 28203 (andrew.simmelink{at}carolinashealthcare.org).

(See page 959 for the Photo Quiz.)

Diagnosis: Mucormycosis.

Histology revealed suppurative granulomatous inflammation, with numerous aggregates of fungal hyphae that appeared degenerated, but broad, ribbon-like, and pauciseptate (Figure 1). Impression was for Zygomycetes infection, and tissue submitted for culture subsequently grew Mucor species.

Figure 1.

Grocott methenamine silver stain of surgical culture, showing numerous aggregates of fungal hyphae that appeared degenerated, but broad, ribbon-like, and pauciseptate, 400x magnification.

Figure 2.

Lateral neck mass.

Mucormycosis is often a rapidly progressive disease with high mortality approaching 30% in some series. This infection most commonly presents with rhinocerebral and pulmonary disease in hosts with diabetes or following solid organ and bone marrow …

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