Apophysomyces elegans Caused Rhino-Orbito Mucormycosis: An Emerging Infection in Immunocompetent Individuals

Abstract

Mucormycosis is a rare necrotizing angioinvasive infection caused by fungi of the class Zygomycetes (order Mucorales). It predominantly occurs in immunocompromised/ predisposed individuals. Recent surge in its incidence in healthy individuals has emphasized the need to reconsider our age-old presumption of 'mucormycosis as a classical opportunistic infection'. Apophysomyces elegans has emerged as a pathogen causing invasive Rhino-Orbitocerebral Mucormycosis (ROCM), mostly in immunocompetent individuals. Mostly resistant to commonly used azoles and echinocandins, management of A elegans associated ROCM solely depends on radical debridement and Amphotericin B. Recent reports of Amphotericin B resistant A elegans strains is disturbing. Till date only 12 cases of ROCM in immunocompetent/ otherwise healthy individuals attributable to A elegans has been reported. Our main objective is to delineate the clinical characteristics and treatment outcome of immunocompentent/ otherwise healthy individuals suffering from A elegans caused ROCM. We also report four new cases of A. elagans caused ROCM. J Microbiol Infect Dis 2017; 7(4):207-212