Saksenaea vasiformis Causing Cutaneous Zygomycosis: An Experience from Tertiary Care Hospital in Mumbai DC01-DC05
Dr. Sulmaz Fayaz Reshi,
Department of Microbiology, Seth GS Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India.
Introduction: Zygomycosis, a fungal infection caused by a group of filamentous fungi, Zygomycetes. Zygomycetes belong to orders Mucorales and Entomorphthorales. Infection occurs in rhinocerebral, pulmonary, cutaneous, abdominal, pelvic and disseminated forms. Cutaneous zygomycosis is the third most common presentation, usually occurring as gradual and slowly progressive disease but may sometimes become fulminant leading to necrotizing lesion and haematogenous dissemination. Infection caused by Saksenaea vasiformis is rare but are emerging pathogens having a tendency to cause infection even in immunocompetent hosts.
Aim: To analyse cases of cutaneous zygomycosis caused by Saksenaea vasiformis with respect to risk factors, clinical presentation, causative agents, management and patient outcome.
Materials and Methods: A retrospective study was conducted at the Department of Microbiology, Seth GS Medical College and KEM Hospital, Mumbai. All the diagnosed cases of cutaneous zygomycosis caused by Saksenaea vasiformis during the period 2010-2017 were included in the study. Case information was retrieved from medical records department. Diagnosis of zygomycosis was based on 10% Potassium Hydroxoide (KOH) examination, culture on Sabouraud’s Dextrose Agar (SDA), identification of fungus by slide culture, Lactophenol Cotton Blue (LPCB) mount and Water Agar method.
Results: In the present study, seven cases of cutaneous Zygomycosis caused by emerging pathogen Saksenaea vasiformis were studied. On analysing these cases, it was found that break in the skin integrity predisposes to infection. Two patients were known cases of Diabetes mellitus, while five of them had no underlying associated medical conditions. This study shows that although infection with Saksenaea vasiformis is more common in immunocompromised patients but a healthy individuals can be infected and may have a bad prognosis if diagnosis and treatment is delayed.
Conclusion: In cases of rapidly progressive necrosis of wound not responding to antibiotics, Saksenaea vasiformis should be considered as one of the aetiological agents and laboratory plays the major role for diagnosing these cases and thereby helps in prompt management of patients.