Entomophthoromycosis: a challenging emerging disease

Abstract

SummaryEntomophthoromycosis is a rare fungal infection that may affect immunocompetent hosts; predominantly in tropical and subtropical regions. Recently, the importance of this emerging mycosis has increased and the scope of its manifestations has been expanded. These manifestations; however, may masquerade as other clinical entities. Prompt diagnosis of this infection requires a high index of suspicion. Although histopathological examination and cultures are the gold standard diagnostic tools; molecular diagnosis is now available and started to play an important role. The cornerstone treatment is prolonged anti-fungal therapy along with surgical debridement. More awareness of this mycosis is warranted for definitive diagnosis and implementation of early proper therapeutic strategies.

First‐time isolation and quantification of Basidiobolus spp. from reptile faeces in KwaZulu‐Natal (South Africa) using selective media

“…Interestingly, cases of more recently reported gastrointestinal infections with Basidiobolus spp. seem to be frequently linked to regions with arid, warm climates such as Arizona (USA) and Saudi Arabia, indicating that Basidiobolus spp. can survive in dry environments.…”

“…could be protected against gastric acid within food vesicles/matrix and its bile tolerance might further safeguard survival in the gastrointestinal tract, promoting gastrointestinal basidiobolomycosis (GIB). Furthermore, as the symptoms of GIB are quite unspecific, the diagnosis is considered difficult, and therefore, a Basidiobolus infection might be misinterpreted and/or remain undetected …”

Rare indolent zygomycosis caused by subcutaneous Saksenaea vasiformis infection

“…Mucorales usually causes systemic mycosis in immunocompromised hosts; accidental skin implantation or secondary bloodstream spreading to the skin can result in severe necrotic, ulcerated lesions . Entomophothorales, on the other hand, results in localised, subcutaneous tropical mycosis characterised by chronic, woody swelling of subcutaneous tissue, with Basidiobolus ranurum infections affecting the limbs or limb‐girdle areas, and Conidiobolus coronatus infections localising on the face . Histologically, all zygomycoses are similar, and thus, species identification by sporulation induction is of paramount importance, as treatments for mucormycosis require intravenous amphotericin B whereas for entomophthoromycosis oral medications may suffice.…”

Rhinofacialentomophthoromycosis

“…It is known to infect nasal mucosa and submucosa forming subcutaneous nodules with the potential to spread to adjacent tissues. Because of this localised spread, it is known as rhinofacial entomophthoromycosis 1. It can be mistaken for malignancy or tuberculosis.…”