Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Mycoses. 2023 Aug;66(8):697-704. doi: 10.1111/myc.13592. Epub 2023 Apr 24.
Saksenaea vasiformis is a rarely reported Mucorales causing mucormycosis in both immunocompromised and immunocompetent individuals. Due to few reported cases, the clinical characteristics and optimal management strategy for this rare agent are not clearly described.
We systematically reviewed Medline, EmBase and CINHAL for studies on S. vasiformis infections reported until 1 January 2022 and 57 studies (63 patients) were retrieved. Additionally, one more case of extensive abdominal wall necrotizing fasciitis managed by our team was also included. The clinical and demographic characteristics and outcomes were extracted and analysed.
Out of the 65 included cases, the majority were reported from India (26.6%). The most common risk factors for infection were accidental trauma wounds (31.3%), health-care-related wounds (14.1%) and animal/insect bites (12.5%). Most common clinical presentation was subcutaneous mucormycosis (60.9%) followed by rhino-orbito cerebral mucormycosis (14%), necrotizing fasciitis (10%), disseminated infection (9.3%), pulmonary mucormycosis (3.2%) and osteomyelitis (1.6%). Mortality was observed in 24 (37.5%) patients and health care related injuries were significantly associated with higher mortality (p = .001). The use of posaconazole (p = .019) and the use of surgical management (p = .032) was associated with significantly better survival.
In this study, we describe the largest compendium of mucormycosis due to S. vasiformis, which can be useful in increasing awareness regarding this rare Mucorales and guiding patient management.
Saksenaea vasiformis 是一种罕见的毛霉目真菌，可引起免疫功能低下和免疫功能正常个体的毛霉菌病。由于报道病例较少，这种罕见病原体的临床特征和最佳治疗策略尚不清楚。
我们系统地检索了 Medline、EmBase 和 CINHAL 中截至 2022 年 1 月 1 日的关于 S. vasiformis 感染的研究，共检索到 57 项研究（63 例患者）。此外，还纳入了我们团队治疗的一例广泛腹壁坏死性筋膜炎的病例。提取并分析了临床和人口统计学特征及结局。
在纳入的 65 例病例中，大多数来自印度（26.6%）。感染的主要危险因素为意外创伤性伤口（31.3%）、与医疗保健相关的伤口（14.1%）和动物/昆虫咬伤（12.5%）。最常见的临床表现为皮下毛霉菌病（60.9%），其次为鼻-眶-脑毛霉菌病（14%）、坏死性筋膜炎（10%）、播散性感染（9.3%）、肺毛霉菌病（3.2%）和骨髓炎（1.6%）。24 例（37.5%）患者死亡，与医疗相关的损伤与较高的死亡率显著相关（p=0.001）。使用泊沙康唑（p=0.019）和手术治疗（p=0.032）与显著改善生存相关。
本研究描述了 S. vasiformis 引起的毛霉菌病的最大病例汇编，有助于提高对这种罕见毛霉目真菌的认识，并指导患者管理。
