Apophysomyces elegans Caused Rhino-Orbito Mucormycosis: An Emerging Infection in Immunocompetent Individuals: Case Series with Review of the Literature

Abstract

Mucormycosis is a rare necrotizing angioinvasive infection caused by fungi of the class Zygomycetes (order Mucorales). It predominantly occurs in immunocompromised/ predisposed individuals. Recent surge in its incidence in healthy individuals has emphasized the need to reconsider our age-old presumption of 'mucormycosis as a classical opportunistic infection'. Apophysomyces elegans has emerged as a pathogen causing invasive RhinoOrbitocerebral Mucormycosis (ROCM), mostly in immunocompetent individuals. Mostly resistant to commonly used azoles and echinocandins, management of A. elegans associated ROCM solely depends on radical debridement and Amphotericin B. Recent reports of Amphotericin B resistant A. elegans strains is disturbing. Till date only 12 cases of ROCM in immunocompetent/ otherwise healthy individuals attributable to A. elegans has been reported.Our main objective is to delineate the clinical characteristics and treatment outcome of immunocompentent/ otherwise healthy individuals suffering from A. elegans caused ROCM. We also report four new cases of A. elagans caused ROCM. J Microbiol Infect Dis 2017; 7(4):207-212

Rhino-Orbital mucormycosis in an immunocompetent pediatric patient with hyperglycemia of the hospitalized patient

“…Although no consistent correlation has been found between the clinical form and the etiological agent, not infrequently, species different than Rhizopus, like Apophysomyces elegans, Cunninghamella spp, Actinomucor elegans, and Conidiobollus spp have been reported in the immunocompetent cases [6,7,9,10].…”