Cranial zygomycosis caused by Saksenaea vasiformis

Abstract

A previously healthy youth who had sustained severe head trauma and had received steroids and broad-spectrum antimicrobial agents developed a cranial zygomycotic infection with Saksenaea vasiformis. This is the first time this zygomycete has been implicated as a disease agent. Early identification of the fungal infection and subsequent vigorous medical and surgical therapy led to recovery.

Zygomycetes in Human Disease

“…The vast majority of cases of S. vasiformis infection resulted from trauma, with introduction of sporecontaining dirt into open lesions. The first reported human case occurred in a previously healthy 19-year-old individual who suffered soil contaminated cranial and facial wounds in an automobile accident (9,112). Soil contamination was likewise the probable source of infection in additional patients who sustained various crush or open injuries (9,75,173,350,366,453).…”

“…Cutaneous lesions with S. vasiformis may present as painful red blisters (332,373), peeling skin with purulent eschar (453), black necrotic ulcers (75,248,464) indurated granulomatous ulcerative lesions (357) or raised red to purple lesions (33,272). Often, the lesions demonstrate seropurulent drainage (9,112,361). Sinus tract or abscess formation has been found in a number of patients (350,366,453).…”

“…Since then, the fungus has been isolated from soil samples in Panama (155), Israel (219), Honduras (177), and the southern United States (201). Cases of human disease occur in the warmer, tropical and subtropical climates and have been found in Mississippi (9,112), Texas (464), Louisiana (332), Utah (229), California (33), Spain (75), Australia (143,173,203,272,350,357,373), Colombia (361), Israel (171,248), Thailand (453), India (77), and Iraq (195).…”

“…The predisposing features to infection included some combination of trauma with open wounds (9,75,77,112,173,272,332,453,464), needle stick trauma (357,361), insect or spider bites (33,77,203), immune system compromise due to steroid treatment (9,112,332,464), antibiotic therapy (9,33,112,195,332,464) or the presence of an indwelling catheter (332). Immune system compromise due to underlying disease also is thought to be a risk factor.…”

Cutaneous Zygomycosis Due toSaksenaea Vasiformis: Case Report and Literature Review

“…4,5 Since then, 19 cases have been reported in the literature (Table 1). In this report, we describe a case of cutaneous zygomycosis caused by S. vasiformis, which to the best of the author's knowledge, is the first reported case from Saudi Arabia.…”