Saksenaeamucormycosis: a rare and dangerous cause of necrotising fasciitis

Abstract

Necrotising fasciitis is a rapidly progressing soft tissue infection requiring early and adequate surgical debridement and appropriate antibiotic cover. The present case highlights bacterial fasciitis associated with fungal (Mucor) infection with insidious angioinvasive nature (Saksenaea vasiformis) which required amputation, negative-pressure vacuum dressings and amphotericin B for definitive treatment. This demonstrates a relatively rare case of the group IV classification of necrotising fasciitis, which we must consider when there is slowly progressing tissue death despite seemingly adequate treatment.

Mucormycosis: update on clinical presentation, diagnosis, and treatment

“…Apophysomyces species are also increasingly described as a cause of MCR and are often associated with trauma and necrotizing fasciitis [20 ▪ ,26 ▪ ]. Saksenaea vasiformis is not necessarily a new cause of MCR but has been recently reported in concert with intravenous drug use and as a cause of necrotizing fasciitis [27,28]. It is possible that infection by new or unusual Mucorales is underrecognized because of the difficulty in culturing them.…”