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Fulminant mucormycosis after a traffic accident: a case report

  • Alicja SękowskaEmail author
  • Małgorzata Prażyńska
  • Magdalena Twarużek
  • Aleksander Deptuła
  • Ewa Zastempowska
  • Ewelina Soszczyńska
  • Eugenia Gospodarek-Komkowska
Short Communication
  • 59 Downloads

Abstract

Mucormycosis is a rare fungal infection in immunocompetent patients, whereas in immunocompromised, it may be systemic and disseminated infection associated with high mortality. Mucormycosis is one of the most rapidly progressing and fulminant forms of fungal infections; Mucor circinelloides is rarely isolated species, also from immunocompromised patients. The reported case of mucormycosis after a traffic accident indicates that it may be the result of a contamination of wound by M. circinelloides coming from the environment. The fungal strain was identified by phenotypic methods and confirmed by molecular methods. Etest method was used for susceptibility testing of the fungal strain. No mycotoxins were detected in the analyzed sample. The infection was successfully treated with amphotericin B, but amputation of the lower limb was necessary.

Notes

Funding

This research was financially supported by the Nicolaus Copernicus University funds for the maintenance of the research potential of the Department of Microbiology.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Afroze SN, Korlepara R, Rao GV, Madala J (2017) Mucormycosis in a diabetic patient: a case report with an insight into its pathophysiology. Contemp Clin Dent 8:662–666CrossRefGoogle Scholar
  2. Arroyo MA, Schmitt BH, Davis TE, Relich RF (2016) Detection of the dimorphic phases of Mucor circinelloides in blood cultures from an immunosuppressed female. Case Rep Infect Dis.  https://doi.org/10.1155/2016/3720549
  3. Bouza E, Munoz P, Guinea J (2006) Mucormycosis: an emerging disease? Clin Microbiol Infect 12:7–23CrossRefGoogle Scholar
  4. Brillowska-Dąbrowska A, Świerkowska A, Lindhardt Saunte DM, Arendrup MC (2010) Diagnostic PCR tests for Microsporum audouinii, M. canis and Trichophyton infections. Med Mycol 48:486–490CrossRefGoogle Scholar
  5. Chan-Tack KM, Nemoy LL, Perencevich EN (2005) Central venous catheter-associated fungemia secondary to mucormycosis. Scand J Infect Dis 37:925–927CrossRefGoogle Scholar
  6. Chandra S, Woodgyer A (2002) Primary cutaneous zygomycosis due to Mucor. Australas J Dermatol 43:39–42CrossRefGoogle Scholar
  7. Dizbay M, Adisen E, Kustimur S (2009) Fungemia and cutaneous zygomycosis due to Mucor circinelloides in an intensive care unit patient: case report and review of literature. Jpn J Infect Dis 62:146–148Google Scholar
  8. Fingeroth JD, Roth RS, Talcott JA, Rinaldi MG (1994) Zygomycosis due to Mucor circinelloides in a neutropenic patient receiving chemotherapy for acute myelogenous leukemia. Clin Infect Dis 19:135–137CrossRefGoogle Scholar
  9. Garcia-Hermoso D, Criscuolo A, Lee SC, Legrand M, Chaouat M, Denis B, Lafaurie M, Rouveau M, Soler C, Schaal JV, Mimoun M, Mebazaa A, Heitman J, Dromer F, Brisse S, Bretagne S, Alanio A (2018) Outbreak of invasive wound mucormycosis in a burn unit due to multiple strains of Mucor circinelloides f. circinelloides resolved by whole-genome sequencing. mBio 9:e00573–e00518CrossRefGoogle Scholar
  10. Gniadek A, Macura AB, Twarużek M, Grajewski J (2010) Cytotoxicity of Aspergillus strains isolated from the neonatal intensive care unit environment. Adv Med Sci 55:242–249CrossRefGoogle Scholar
  11. Greenberg RN, Mullane K, van Burik JA (2006) Posaconazole as salvage therapy for zygomycosis. Antimicrob Agents Chemother 50:126–133CrossRefGoogle Scholar
  12. Hamdi T, Karthikeyan V, Alangaden GJ (2014) Mucormycosis in a renal transplant recipient: case report and comprehensive review of literature. Int J Nephrol.  https://doi.org/10.1155/2014/950643
  13. Hollmann M, Razzazi-Fazeli E, Grajewski J, Twaruzek M, Sulyok M, Böhm J (2008) Detection of 3-nitropropionic acid and cytotoxicity in Mucor circinelloides. Mycotoxin Res 24:140–150CrossRefGoogle Scholar
  14. Inglesfield S, Jasiulewicz A, Hopwood M, Tyrrell J, Youlden G, Mazon-Moya M, Millington OR, Mostowy S, Jabbari S, Voelz K (2018) Robust phagocyte recruitment controls the opportunistic fungal pathogen Mucor circinelloides in innate granulomas in vivo. mBio 9:e02010–e02017CrossRefGoogle Scholar
  15. Karthaus M, Cornely OA (2006) Second-line treatment in invasive mould infections. Mycoses 49:23–26CrossRefGoogle Scholar
  16. Kordalewska M, Brillowska-Dąbrowska A, Jagielski T, Dworecka-Kaszak B (2015) PCR and real-time PCR assays to detect fungi of Alternaria alternata species. Acta Biochim Pol 62:707–712CrossRefGoogle Scholar
  17. Lee SC, Billmyre RB, Li A, Carson S, Sykes SM, Huh EY, Mieczkowski P (2014) Analysis of a food-borne fungal pathogen outbreak: virulence and genome of a Mucor circinelloides isolate from yogurt. mBio 5:e01390–e01314Google Scholar
  18. Pitt Ji and Hocking AD (1999) Fungi and Food Spoilage. Springer, pp 19–52Google Scholar
  19. Ribes JA, Vanover-Sams CL, Baker DJ (2000) Zygomycetes in human disease. Clin Microbiol Rev 13:236–301CrossRefGoogle Scholar
  20. Samson RA (2010) Food and indoor fungi. CBS-KNAW Fungal Biodiversity Centre Utrecht, The NetherlandsGoogle Scholar
  21. Stasiak M, Samet A, Lasek J, Wujtewicz M, Witkowski Z, Komarnicka J, Gołąbek-Dropiewska K, Rybak B, Gross M, Marks W (2009) Mucormycosis complicating lower limb crash injury in a multiple traumatised patient: an unusual case. BMJ Case.  https://doi.org/10.1136/bcr.10.2008.1170
  22. Viegas C, Faria T, de Oliveira AC, Caetano LA, Carolino E, Quintal-Gomes A, Twarużek M, Kosicki R, Soszczyńska E, Viegas S (2017) A new approach to assess occupational exposure to airborne fungal contamination and mycotoxins of forklift drivers in waste sorting facilities. Mycotoxin Res 33:285–295CrossRefGoogle Scholar
  23. Walther G, Pawłowska J, Alastruey-Izquiero A, Wrzosek M, Rodriguez-Tudela JL, Dolatabadi S, Chakrabarti A, de Hoog GS (2013) DNA barcoding in Mucorales: an inventory of biodiversity. Persoonia 30:11–47CrossRefGoogle Scholar
  24. White TJ, Bruns T, Lee S, Taylor JW (1990) Amplification and direct sequencing of fungal ribosomal RNA genes for phylogenetics. In: Innis MA, Gelfand DH, Sninsky JJ, White TJ (eds) PCR protocols: a guide to methods and applications. Academic Press, Inc, New York www.uniprot.org/taxonomy (downloaded on 11/Feb/2018)Google Scholar

Copyright information

© Institute of Microbiology, Academy of Sciences of the Czech Republic, v.v.i. 2019

Authors and Affiliations

  1. 1.Department of Microbiology, Ludwik Rydygier Collegium MedicumNicolaus Copernicus UniversityBydgoszczPoland
  2. 2.Department of Physiology and Toxicology, Institute of Experimental Biology, Faculty of Natural SciencesKazimierz Wielki UniversityBydgoszczPoland

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