Saksenaea vasiformis infections: Case report and literature review

Vega, William A.; Orellana, M. G.; Zaror, Luis; Gené, Josepa; Guarro, Josep

doi:10.1007/s11046-006-0061-6

Cited by 47 publications

(35 citation statements)

References 25 publications

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“…Up to now, approximately 40 cases of zygomycete infections, mostly cutaneous infections, have been attributed to Saksenaea (6,40,46,47), although for the reasons indicated above, it is likely that the actual number of clinical cases has been underestimated. To avoid difficulties in the detection and identification of Saksenaea in clinical samples, several authors have emphasized the need for special culture techniques, such as the use of floating agar blocks on water, or the use of BorelliЈs lactrimel agar (15,29) to induce sporulation.…”

Section: Discussionmentioning

confidence: 99%

“…Mucormycosis caused by S. vasiformis most often occurs after traumatic implantation of the fungus but can also be due to inhalation of spores (18), spider bites, insect stings, and the use of indwelling catheters (11,22,28,31). Clinical cases seems to be more common in tropical and subtropical climates than elsewhere and have been reported from Australia (16,19,22,40,48), India (6,7,11,33), the United States (1,8,31,35,45), Thailand (44), Tunisia (28), the Middle East (2,25), and Central and South America (9,47).…”

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confidence: 99%

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Molecular Phylogeny and Proposal of Two New Species of the Emerging Pathogenic FungusSaksenaea

et al. 2010

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Saksenaea is a monotypic genus belonging to the order Mucorales and capable of producing severe human infections. Through a polyphasic study based on analysis of the sequences of the internal transcribed spacer (ITS) region, domains D1 and D2 of the 28S rRNA gene, and the elongation factor 1␣ (EF-1␣) gene, as well as by evaluation of relevant morphological and physiological characteristics of a set of clinical and environmental strains, we have demonstrated that Saksenaea vasiformis is a complex of species. We propose as new species Saksenaea oblongispora, characterized by oblong sporangiospores and unable to grow at 42°C, and Saksenaea erythrospora, characterized by large sporangiophores and sporangia and by ellipsoid sporangiospores, biconcave in the lateral view. Itraconazole, posaconazole, and terbinafine were active against all isolates included in the study, while amphotericin B, voriconazole, and the echinocandins showed low activity.The genus Saksenaea S. B. Saksena, belonging to the subphylum Mucoromycotina, was first isolated from a forest soil in India (38). Saksenaea vasiformis S. B. Saksena, the only species of the genus, is a filamentous fungus reported in soil, driftwood, and grains (1, 12, 34), characterized by flask-shaped sporangia, short sporangiophores, oval sporangiospores, and dark rhizoids. It is a thermotolerant fungus that grows between 25°C and 44°C (13, 24, 44) and is able to cause severe human infections in both immunocompromised and immunocompetent hosts. Mucormycosis caused by S. vasiformis most often occurs after traumatic implantation of the fungus but can also be due to inhalation of spores (18), spider bites, insect stings, and the use of indwelling catheters (11,22,28,31). Clinical cases seems to be more common in tropical and subtropical climates than elsewhere and have been reported from Australia (16,19,22,40,48), India (6,7,11,33), the United States (1,8,31,35,45), Thailand (44), Tunisia (28), the Middle East (2, 25), and Central and South America (9, 47).Recent molecular studies, based mostly on internal transcribed spacer (ITS) sequences, which have proven to be a good phylogenetic marker in the Mucorales (5), have demonstrated unexpectedly high genetic diversity within the most relevant clinical species of this order (3,4,21). In the case of Saksenaea vasiformis, a few studies have also demonstrated relatively high intraspecific genetic diversity (9, 28), suggesting that more than one phylogenetic species may be present within this morphospecies.To identify possible cryptic species in S. vasiformis, we performed a polyphasic study, based on sequence analysis of three loci, and evaluated different morphological and physiological characteristics for a diverse panel of strains. MATERIALS AND METHODSFungal strains. A total of 11 strains from different reference culture collections were included in the study (Table 1) DNA extraction, amplification, and sequencing. For sequencing of the ITS region, DNA was extracted and purified directly from fungal colonies by following a sl...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Molecular Phylogeny and Proposal of Two New Species of the Emerging Pathogenic FungusSaksenaea

et al. 2010

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“…S. vasiformis has been recovered from soil and diseased humans and animals. Human infection with this mucoraceous mold is typically seen after trauma, including burns, and is associated with contamination with soil (4,5,7,9,10,11). Severe infection following penetrating trauma with contamination with soil is commonly associated with members of (5,11).…”

Section: Case Reportmentioning

confidence: 99%

Saksenaea erythrospora Infection following Combat Trauma

et al. 2011

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Saksenaea erythrospora is a newly described species of the order Mucorales which has not previously been reported as a cause of human infection. We report a fatal case of S. erythrospora invasive burn wound infection in a 26-year-old male injured during combat operations in Iraq. CASE REPORTA 26-year-old male sustained 56% total body surface area burns following an improvised explosive device blast in Iraq in November 2005. Injuries were significant for deep, fullthickness facial burns and partial-thickness and full-thickness burns affecting his head, arms, and legs. No evidence of significant smoke inhalation injury was noted on fiber-optic bronchoscopy. At a combat support hospital in Iraq, he was resuscitated and taken to the operating room for bilateral canthotomies, four extremity escharotomies, and four extremity fasciotomies. After initial stabilization, he was evacuated to Germany, where he was found to be in persistent circulatory shock and taken back to the operating room. He was found to have nonviable muscle in the right anterior tibialis compartment, and muscle debridement was performed. He was subsequently stabilized and transferred to the U.S. Army Institute of Surgical Research burn center approximately 4 days postburn. On postburn day 5, the patient underwent tangential excision of his extremity burn wounds and split-thickness skin graft placement. On postburn day 14, the patient was found to have proptosis of his left eye on a routine physical evaluation and underwent a head computed tomography (CT) scan. The CT scan revealed displacement of his left orbit in the inferior lateral direction due to swelling in the orbital fossa. He was rushed to the operating room, where he underwent enucleation of the left eye and debridement of nonviable-appearing tissue in the orbital fossa. Histopathology of the surgical specimen revealed mucormycosis (Fig. 1). Broad-width, aseptate hyphae consistent with Mucorales infection (mucormycosis) were noted on histopathologic examination of tissue from his head and neck multiple times during subsequent serial wound debridements over the course of his hospitalization (days 19, 20, 21, 52, and 85). Multiple cultures were obtained over the course of this management, including mycologic cultures. Most of the fungal cultures were overgrown with bacteria, but they occasionally revealed broad, ribbonlike hyphae on Calcofluor staining. A single culture recovered Saksenaea erythrospora during the course of his hospitalization. The mold was recovered from scalp wound fluid placed into blood culture (aerobic) medium on day 19 postinjury.In addition to radical debridement, flap coverage of the left side of his face was attempted on two separate occasions during the course of his hospitalization. Both of these attempts were unsuccessful. His course was also complicated by recurrent bacterial infections and sepsis, in addition to this inability to control his facial mucormycosis, and 100 days following his initial injury, he expired. At autopsy, invasive fungal infection of the l...

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“…En términos generales, se conoce la nula capacidad de penetración transcutánea espontánea por parte de los Mucorales. Sin embargo, procesos tales como quemaduras, laceraciones, maceraciones de la piel (Ledgard et al, 2008;Stewardson et al, 2009;Vega et al, 2006), picaduras de insectos o pájaros (Lechevalier et al, 2008;SaraviaFlores et al, 2010;Wilson, 2008), inoculación traumática (Andresen et al, 2005;Ribes et al, 2000;Snell y Tavakoli, 2007), y cualquier proceso de alteración de esta barrera permiten la entrada y la colonización de los tejidos por parte de dichos microorganismos.…”

Section: Epidemiología De Las Mucormicosisunclassified

El Subphylum Mucoromycotina: generalidades y aspectos taxonómicos recientes

Duarte

2013

Bol. Micol.

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El subphylum Mucoromycotina es un grupo de hongos ubicuos, saprobios, caracterizados por la presencia de hifas cenocíticas. También se caracterizan por presentar una fase sexual con la formación de una zigospora. Los mucormycetes son capaces de infectar plantas, animales y seres humanos. Recientemente, varios estudios han comunicado de la creciente incidencia de mucormicosis en pacientes inmunocomprometidos e inmunocompetentes. Dados los avances en biología molecular, la sistemática de este grupo de hongos ha experimentado varios cambios taxonómicos en los últimos años. Este artículo discutirá los principales cambios taxonómicos, en especial de los géneros y especies de interés clínico. ABSTRACTThe subphylum Mucoromycotina is a group of fungi with several ubiquitous, and saprotrophic species which are characterized by the presence of coenocytic hyphae. Also have a sexual phase characterized by the formation of zygospores. The mucormycetes are able to infect plants, animals and humans. Recently, several studies have reported the increasing incidence of mucormycosis in both immunocompromised and immunocompetent patients. Given the advances in molecular biology, the systematic of this group of fungi has experimented several taxonomical changes. This paper will discuss the major taxonomic changes, particularly of those genera and species of clinical interest.

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Saksenaea vasiformis infections: Case report and literature review

Cited by 47 publications

References 25 publications

Molecular Phylogeny and Proposal of Two New Species of the Emerging Pathogenic FungusSaksenaea

Molecular Phylogeny and Proposal of Two New Species of the Emerging Pathogenic FungusSaksenaea

Saksenaea erythrospora Infection following Combat Trauma

El Subphylum Mucoromycotina: generalidades y aspectos taxonómicos recientes

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