Humeral Osteomyelitis with Apophysomyces ossiformis in an Immunocompetent Patient: A Case Report

Abstract

Introduction: Osteomyelitis of a limb can lead to devastating functional consequences. Fungal osteomyelitis is rare in immunocompetent patients, and compared to bacterial osteomyelitis, fungal infections are more difficult to eradicate. Case Report: We present a case of a 59-year-old male who suffered traumatic left open radius and ulna fractures at the elbow with significant soft tissue loss. He underwent spanning fixation across the elbow, and soft tissue coverage was provided with a free latissimus flap. At the time of flap coverage, the patient was found to have fungal osteomyelitis with the organism Apophysomyces ossiformis. The patient achieved wound closure and functional use of the left upper extremity. Conclusion: The reported case demonstrates the pathogenicity of a microorganism not previously described in human disease. In this case, treatment was successful with local debridement, placement of antibiotic beads, and long-term antifungal therapy.

Rhino-orbital mucormycosis due to Apophysomyces ossiformis in a patient with diabetes mellitus: a case report

“…have emerged as pathogens in both immunocompetent and immunocompromised individuals [5,6,11]. Although A. elegans was historically considered the only pathogenic species, other species (A. mexicanus, A. ossiformis, A. trapeziformis and A. variabilis) have been recently reported as infectioncausing agents [5][6][7]. The only case of infection by A. ossiformis was reported in an immunocompetent patient with humeral osteomyelitis [7].…”

“…trapeziformis and A. variabilis ) have been recently reported as infection-causing agents [ 5 – 7 ]. The only case of infection by A. ossiformis was reported in an immunocompetent patient with humeral osteomyelitis [ 7 ]. In this work we report a rhino-orbital mucormycosis due to A. ossiformis in a patient with diabetes mellitus.…”

“…The genus Apophysomyces includes six species ( A. elegans , A. mexicanus , A. ossiformis , A. thailandensis , A. trapeziformis , and A. variabilis ), and only A. elegans , A. mexicanus , A . ossiformis and A. variabilis have been reported to cause infections in both immunocompetent and immunocompromised patients [ 5 – 7 ]. We present the first case of rhino-orbital mucormycosis due to A. ossiformis in a patient with poorly controlled diabetes from the central region of Mexico.…”