Insect Bite-Associated Invasive Fungal Infections
Panayiotis D Kontoyiannis1,2, Gerry L Koons2,3, Rachel S Hicklen4
1Department of Biochemistry and Cell Biology, Rice University, Houston, Texas.
Open Forum Infectious Diseases
|October 30, 2019
Summary
Insect bites can lead to rare fungal infections of the muscle and skin (myocutaneous mycoses). Molds, particularly Mucorales, were common culprits in these severe, often misdiagnosed cases.
Area of Science:
- Mycology
- Infectious Diseases
- Dermatology
Background:
- Myocutaneous mycoses are uncommon infections affecting both muscle and skin.
- Insect bites are an underrecognized potential route for inoculation of fungal pathogens.
Purpose of the Study:
- To investigate the occurrence and characteristics of myocutaneous mycoses following insect bites.
- To highlight the diagnostic challenges and clinical outcomes associated with these infections.
Main Methods:
- A comprehensive literature review was conducted.
- Analysis of 22 reported cases of myocutaneous mycoses potentially linked to insect bites.
Main Results:
- Molds were the predominant fungal pathogens identified (15 cases), with Mucorales being particularly frequent (9 cases).
- A significant proportion of infections (68%) exhibited necrotizing features, often necessitating extensive surgical intervention, including amputation.
- Cases occurred in both immunocompetent and immunosuppressed individuals, indicating a broad susceptibility.
Conclusions:
- Insect bites represent a rare but serious inoculation route for myocutaneous mycoses.
- These fungal infections are frequently misdiagnosed and characterized by severe, necrotizing pathology.
- Prompt recognition and appropriate management are crucial for improving outcomes in affected patients.
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