Disseminated Infection due to Saksenaea vasiformis Secondary to Cutaneous Mucormycosis

Abstract

Mucormycosis is an uncommon opportunistic fungal infection caused by Zygomycetes. It usually affects immunocompromised, diabetic and trauma patients with infected wounds. We report a case of disseminated infection secondary to facial cutaneous mucormycosis caused by Saksenaea vasiformis in a diabetic patient who had a farming accident causing him severe head injury. The patient was treated with a combination of surgical debridement and antifungal therapy with liposomal amphotericin B, but he had a slow and fatal outcome. In cases of tissue necrosis following trauma involving wound contact with soil (i.e., potential fungal contamination), testing for the presence of Zygomycetes fungi such as S. vasiformis in both immunocompetent and immunocompromised patients is crucial. The reason is that this infection usually has a rapid progression and may be fatal if appropriate treatment is not administered.

Disseminated Saksenaea infection in an immunocompromised host associated with a good clinical outcome: a case report and review of the literature

“…Unlike other members of the order Mucorales, Saksenaea infections usually affect immunocompetent hosts, and are often associated with trauma [13]. To our knowledge, there have been six cases of disseminated Saksenaea infection reported; these are summarized in Table 1 [14][15][16][17][18][19]. Two of these cases had renal involvement, and all six cases had cutaneous lesions.…”

Acute ischemia of bilateral lower extremities as a presenting feature of disseminated mucormycosis endocarditis: A case report

“…Mucormycosis is a rare opportunistic fungal infection caused by Mucorales fungi (3). It occurs almost exclusively in persons with immunosuppression (1, 3, 4).…”

“…It occurs almost exclusively in persons with immunosuppression (1, 3, 4). Although rhinocerebral mucormycosis is the commonest presentation, it may present as pulmonary, cutaneous, gastrointestinal, or disseminated infection (3).…”

“…It occurs almost exclusively in persons with immunosuppression (1, 3, 4). Although rhinocerebral mucormycosis is the commonest presentation, it may present as pulmonary, cutaneous, gastrointestinal, or disseminated infection (3). Our patient presented with acute bilateral lower limb ischemia and also had multiple septic emboli in spleen and kidneys, which, to the best of our knowledge, has never before been reported in the literature.…”

“…Surgical debridement of necrotic tissue along with early administration of antifungal agent is the mainstay of treatment (1–3, 5). Despite adequate and aggressive surgical and medical management, outcome is usually dismal (1).…”