Apophysomyces variabilis as an emerging pathogen in Mainland China

Area of Science:

• Mycology
• Infectious Diseases
• Medical Mycology

Background:

• Mucormycosis is a severe fungal infection caused by Mucorales.
• While Rhizopus arrhizus is common, Apophysomyces variabilis infections are rising.
• This study focuses on A. variabilis in an immunocompetent patient.

Observation:

• A case of necrotizing fasciitis caused by A. variabilis in an immunocompetent woman is presented.
• The isolated strain's characteristics were analyzed, including ITS sequencing, salt tolerance, and temperature resistance.
• In vitro antifungal drug susceptibility testing was performed.

Findings:

• The A. variabilis strain showed high identity (98.76%) in the NCBI database.
• The strain exhibited greater tolerance to salt and temperature than previously documented.
• Sensitivity was observed for amphotericin B and posaconazole, but not voriconazole, itraconazole, 5-fluorocytosine, or echinocandins.

Implications:

• Apophysomyces variabilis is an emerging pathogen causing mucormycosis with high mortality.
• Prompt diagnosis and treatment are vital, especially in China.
• Aggressive surgical debridement and appropriate antifungal therapy can improve patient outcomes.