Phylogenetic analysis reveals two genotypes of the emerging fungus Mucor indicus, an opportunistic human pathogen in immunocompromised patients

Abstract

Mucormycosis is a rare fungal infection caused by Mucor indicus. Phylogenetic analysis of many M. indicus isolates, mainly sampled from different clinical and environmental specimens collected worldwide, revealed two genotypes, I and II, based on ITS and D1/D2 LSU rDNA sequences. A retrospective review of the literature revealed 13 cases. Eight (76.9%) patients had disseminated infections, and the overall mortality rate was 30.7%. A pulmonary infection caused by M. indicus genotype I in a liver transplant recipient was disseminated to include the skin and was successfully treated with liposomal amphotericin B and aggressive surgery. M. indicus can infect a wide variety of patients with no real preference for the site of infection. We concluded that M. indicus has emerged as a significant cause of invasive mycosis in severely immunocompromised patients worldwide. Early diagnosis and initiation of appropriate therapy could enhance survival in these immunocompromised patient populations.

Rhizomucor hepatosplenic abscesses in a patient with renal and pancreatic transplantation

“…Mucormycosis occurs in 0.2% of cases after solid organ transplantation. 4 Rhino-orbito-cerebral infiltration is the most frequent localisation, followed by the pulmonary tract. Disseminated disease is very rare and can cause a fulminant infection with a high mortality rate above 40%, even with adequate antifungal therapy and surgical care.…”

Left hand necrosis as the initial presentation of disseminated mucormycosis: A case report and literature review

“… Author Year Age/Gender Organism Immunocompromised State Cutaneous Location Other Organs Involved Antimicrobials, (Dosage) Clinical Course Ding [3] 2020 52/M Mucor spp. Acute Lymphoblastic Leukemia Thigh (Present 10 Days Prior to Hospital Admission) Lungs Amphotericin B (50 mg/d), Posaconazole (800 mg/d) Resolution 4 weeks after treatment Menzinger [4] 2019 27/W Rhizomucor pusillus Acute Myelomonocytic Leukemia with Immunosuppressive Therapy Palm Lungs Not Specified Not Specified Taj-Aldeen [6] 2017 55/M Mucor indicus Diabetes, Liver Transplant with Tacrolimus and Mycophenolate Therapy, High-Dose Prednisolone Therapy for Pneumocystis jirovecii Infection Knee, Thigh Right Lung Liposomal Amphotericin B (5 mg/kg/d) and Piperacillin/Tazobactam followed by R. Anterolateral 5th Intercostal Thoracotomy for Removal of Fungus Ball Discharge after 3 months of antifungal therapy and surgical intervention Iyengar [7] 2017 60/M Rhizopus spp Chronic Lymphocytic Leukemia Thigh, Chest Lungs Liposomal Amphotericin B (2 doses of 3 mg/kg/day followed by 500 mg IV daily) Death due to acute left cerebellar infarct related to fungal emboli and acute respiratory failure 5 days after admission Kanemaru [8] 2016 62/W Rhizopus oryzae Treatment-Related Myelodysplastic Syndrome with Bone Marrow Transplant Right Lower Limb Lungs Liposomal Amphotericin B (3 mg/kg/d) Death 2 weeks after admission for cutaneous lesions Peixoto [9] 2014 59/M Rhizomucor pusillus and miehei Acute Myelogenous Leukemia Face, Scalp, Neck, Back Right Lu...…”

Separation, Purification, Structural Characterization, and Anticancer Activity of a Novel Exopolysaccharide from Mucor sp.

“…Mucor sp., a zygomycete filamentous fungus often found in natural environments such as soils, air, fruits, and vegetables, reproduces rapidly and its hyphae develop densely [ 1 ]. Some thermotolerant species (such as M. indicus and M. ramosissimus ) are obligate pathogens that affect animal and human health [ 2 , 3 ]. However, proteases, amylases, and lipases, produced by several Mucor species, including M. circinelloides , M. flavus , M. hiemalis , M. mucedo , and M. racemosus , hydrolyze soy components, such as proteins, carbohydrates, and fats, in the process of making classic Asian and African fermented cuisines, such as sufu, ragi, tempeh, furu, and mureha [ 4 , 5 , 6 ].…”