Mucormycosis caused by Apophysomyces species: An experience from a tertiary care hospital in Western India and systematic review of global cases

Abstract

Mucormycosis is a devastating angioinvasive disease caused by fungi belonging to the order Mucorales. These fungi gain entry into the human body via respiratory tract or skin, and less commonly through the gastrointestinal tract. They have a predilection to invade the blood vessels and cause extensive thrombosis and ischaemic tissue necrosis.The three genera of Mucorales-Rhizopus, Mucor and Lichtheimia account for 70-80% of the mucormycosis cases worldwide. Other less frequent genera include Rhizomucor, Apophysomyces, Cunninghamella,

Mucormycosis: update on clinical presentation, diagnosis, and treatment

“…New species are being described, such as Rhizopus homothallicus , which has been associated with reduced mortality and lower minimum inhibitory concentrations to amphotericin B, itraconazole, posaconazole, and isavuconazole compared with prior described Rhizopus species [25 ▪ ]. 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].…”

Epidemiology, Modern Diagnostics, and the Management of Mucorales Infections

“…These variations are likely attributable to endemicity in the environment, as well as pathophysiological factors such as temperature-dependent growth parameters. For instance, Apophysomyces cases comprise the second most reported Mucorales infections in India, possibly due to the thermotolerant nature of the fungus and its ubiquitous presence the local environment [ 44 , 45 ]. Conversely, Apophysomyces cases have been less commonly described in Africa and Europe, while Lichtheimia is responsible for a greater proportion of European cases [ 2 ].…”