Inadvertent inoculation of Apophysomyces following tetanus immunisation- a case report

Area of Science:

• Mycology
• Infectious Diseases
• Dermatology

Background:

• Mucormycosis is a rare, life-threatening fungal infection.
• Typically affects immunocompromised individuals, but can occur in immunocompetent hosts, especially after trauma.
• The Apophysomyces subspecies are particularly challenging to isolate and identify.

Observation:

• A case of cutaneous mucormycosis caused by Apophysomyces complex is reported.
• The infection occurred at a vaccination site in a 17-year-old immunocompetent female following a motor vehicle accident.
• The patient required multiple hospital admissions and radical surgical debridement of her left upper limb.

Findings:

• This case highlights the aggressive nature of Apophysomyces-associated mucormycosis.
• Early clinical recognition is critical for effective management.
• Aggressive surgical debridement is often necessary prior to microbiological confirmation.

Implications:

• Emphasizes the need for heightened clinical suspicion for mucormycosis in immunocompetent individuals with severe trauma or unusual infections.
• Underscores the importance of prompt and aggressive surgical intervention in managing this potentially fatal condition.
• Suggests that vaccination sites, especially after trauma, could be a potential inoculation point for such infections.