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Severe osteomyelitis due to the zygomycete Apophysomyces elegans
J F Meis1, B J Kullberg, M Pruszczynski
1Department of Medical Microbiology, University Hospital St. Radboud, Nijmegen, The Netherlands.
Journal of Clinical Microbiology
|December 1, 1994
Summary
A rare zygomycete infection, Apophysomyces elegans, caused humerus osteomyelitis in an immunocompetent man. Aggressive antifungal treatment was insufficient, necessitating amputation due to rapid fungal spread.
Area of Science:
- Mycology
- Infectious Diseases
- Surgical Pathology
Background:
- Osteomyelitis is a serious bone infection.
- Zygomycetes are a class of fungi, some of which can cause severe infections in humans.
- Apophysomyces elegans is a rare zygomycete, with limited documented human infections.
Observation:
- A previously healthy 69-year-old man developed humerus osteomyelitis.
- The infection was caused by Apophysomyces elegans, acquired in Aruba.
- The patient had no history of diabetes or immune defects.
Findings:
- The skin was the most likely entry point, despite no history of trauma.
- Treatment with amphotericin B (7.9 g) was unsuccessful in controlling the infection.
- An interthoracoscapular amputation was required to manage the rapid fungal spread.
Implications:
- This case highlights the potential for Apophysomyces elegans to cause severe invasive infections in immunocompetent hosts.
- It underscores the importance of considering rare fungal pathogens in unexplained osteomyelitis.
- Aggressive surgical intervention may be necessary for rapidly progressing zygomycete infections.