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Necrotizing fasciitis from invasive Phycomycetes.

W D Newton, F S Cramer, S H Norwood

    Critical Care Medicine
    |April 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

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    Early aggressive treatment is crucial for invasive phycomycosis. Hyperbaric oxygen (HBO) therapy did not halt fungal infection progression, highlighting the necessity of surgical debridement for invasive fungal infections.

    Area of Science:

    • Mycology
    • Infectious Diseases
    • Hyperbaric Medicine

    Background:

    • Invasive phycomycosis poses a severe threat to immunocompromised individuals, necessitating prompt and aggressive treatment strategies.
    • Hyperbaric oxygen (HBO) therapy is explored as an adjunct treatment for fungal infections, supported by in vitro data and theoretical benefits.
    • Phycomycetes, specifically Apophycomyces elegans, are rarely implicated as human pathogens.

    Observation:

    • A case of progressive necrotizing polymicrobial soft-tissue infection of the lower extremity in a patient with normal immunity was treated.
    • A standard gas gangrene hyperbaric oxygen (HBO) protocol was administered as part of the treatment regimen.
    • The patient's fungal infection showed continued progression despite the HBO therapy.

    Findings:

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    • Radical surgical debridement was the definitive intervention that halted the progression of the fungal infection.
    • The study identified Apophycomyces elegans as a causative agent in a human soft-tissue infection, a previously unreported finding.
    • Hyperbaric oxygen therapy, under the employed protocol, did not demonstrate efficacy in controlling the invasive fungal infection.

    Implications:

    • This case underscores the critical role of surgical intervention in managing invasive fungal infections, even with adjuvant therapies.
    • The identification of Apophycomyces elegans as a human pathogen expands the spectrum of known fungal infections.
    • Further research is needed to determine the precise role and optimal protocols for hyperbaric oxygen therapy in managing invasive fungal infections.