448
Indian Journal of Medical Microbiology
5. Devi dRG, idumati VA, Indra S, BabuPRS, Sridharan D, Belwadi MRS. Injection site abscess due to Mycobacterium fortuitum: Indian. J Med Microbiol 2003;21(2):133-4 6. Sethi S, Sharma M, Ray P, Singh M, GuptaA.Microbacterial wound infection following leproscopy. Indian J Med Res 2001;113:83-4 7. O` Brien RJ, Geiter L J, snider DE. Epidemiology of nontubercuious mycobacterial diseases in the United States. Am review of Respir Dis. 1987;135:1007-14 8. DalovisioJR Panky GA, Wallace RJ, Jones DB. Clinical usefulness of Amikacin and Doxycycline in the treatment of infection due to M fortuitum and M. chelonae, Review of Inf Disease. 1981;3:1068-74
vol. 32, No. 4 Access this article online
Quick Response Code:
Website: www.ijmm.org PMID: *** DOI: 10.4103/0255-0857.142251
How to cite this article: Tankhiwale SS, Katkar VJ. Subdural empyma due to Mycobacterium fortuitum in a non-HIV patient. Indian J Med Microbiol 2014;32:446-8. Source of Support: Nil, Conflict of Interest: None declared.
A rare case of subcutaneous mucormycosis due to Syncephalastrum racemosum: Case report and review of literature *S Mangaraj, G Sethy, MK Patro, S Padhi
Abstract Zygomycosis represent a group of uncommon but potentially fatal fungal infections. The incidence of zygomycosis has increased manifold in recent years. Despite aggressive treatment, it can lead to a highly invasive disease state with fatal outcomes, especially among immuno‑compromised. Syncephalastrum racemosum is a fungus belonging to Zygomycetes. Very few cases of human disease caused by this particular fungus have been documented. However, it has been clearly implicated in causing highly invasive disease in recent reported cases. Knowledge about the pathogenicity and clinical presentation of this rare fungal infection will alert the clinicians for instituting an early appropriate therapy leading to better outcomes. Key words: Mucormycosis, Subcutaneous mucormycosis,Syncephalastrum racemosum
Introduction Mucormycosis (Zygomycosis) represent a spectrum of emerging infections caused by ubiquitous fungal pathogens. S. racemosum is a fungus belonging to order Mucorales, which has very rarely been implicated in causing human disease. Less than 10 cases have been reported in medical literature. We report a case of an adult diabetic male who developed locally invasive cutaneous disease due to S. racemosum. Case Report A 45-year‑old male, a farmer, presented to us with *Corresponding author (email: Department of Internal Medicine (SM, GS), Department of Pathology (MKP), Department of Microbiology (SP), Maharaja Krishna Chandra Gajapati Medical College, Berhampur, Odisha, India. Received: 03-09-2013 Accepted: 06-02-2014
development of a swelling in anterior chest wall in the left side during a routine follow up. There was no history of fever, cough, haemoptysis, weight loss, headache, altered sensorium, nasal discharge, visual problem or vomiting. There was no history of any trauma to the affected site. His significant past history included an episode of diabetic ketoacidosis 2 months back, which was successfully managed at our unit. The patient was a diagnosed case of type 2 diabetes mellitus for past 1 year and was on oral hypoglycaemic drugs. Despite repeated advice, his adherence to medication was poor. The patient was normotensive. There was no history of tuberculosis in the past. On examination, the patient was conscious and afebrile. He had a blood pressure of 130/80 mmHg and a respiratory rate of 16/min. There was no evidence of pallor, icterus, clubbing or lymphadenopathy. Systemic examination was unremarkable. There was a solitary swelling of about 3 × 2 cm in the left side of anterior chest wall. The
www.ijmm.org
October - December 2014
Case Reports
449
lesion was firm, non‑fluctuant, adherent to underlying fascia and was slightly tender. There were no local signs of inflammation or any evidence of necrotic tissue or discharging sinus. The swelling had developed gradually over a period of 1 month. His routine blood investigation including complete blood count, renal function test, liver function test, electrolyte panel all were within normal limit. Fasting and post‑prandial blood glucose levels were 160 and 240 mg/dl, respectively. He had a glycosylated haemoglobin level of 9% (normal
Indian Journal of Medical Microbiology
5. Devi dRG, idumati VA, Indra S, BabuPRS, Sridharan D, Belwadi MRS. Injection site abscess due to Mycobacterium fortuitum: Indian. J Med Microbiol 2003;21(2):133-4 6. Sethi S, Sharma M, Ray P, Singh M, GuptaA.Microbacterial wound infection following leproscopy. Indian J Med Res 2001;113:83-4 7. O` Brien RJ, Geiter L J, snider DE. Epidemiology of nontubercuious mycobacterial diseases in the United States. Am review of Respir Dis. 1987;135:1007-14 8. DalovisioJR Panky GA, Wallace RJ, Jones DB. Clinical usefulness of Amikacin and Doxycycline in the treatment of infection due to M fortuitum and M. chelonae, Review of Inf Disease. 1981;3:1068-74
vol. 32, No. 4 Access this article online
Quick Response Code:
Website: www.ijmm.org PMID: *** DOI: 10.4103/0255-0857.142251
How to cite this article: Tankhiwale SS, Katkar VJ. Subdural empyma due to Mycobacterium fortuitum in a non-HIV patient. Indian J Med Microbiol 2014;32:446-8. Source of Support: Nil, Conflict of Interest: None declared.
A rare case of subcutaneous mucormycosis due to Syncephalastrum racemosum: Case report and review of literature *S Mangaraj, G Sethy, MK Patro, S Padhi
Abstract Zygomycosis represent a group of uncommon but potentially fatal fungal infections. The incidence of zygomycosis has increased manifold in recent years. Despite aggressive treatment, it can lead to a highly invasive disease state with fatal outcomes, especially among immuno‑compromised. Syncephalastrum racemosum is a fungus belonging to Zygomycetes. Very few cases of human disease caused by this particular fungus have been documented. However, it has been clearly implicated in causing highly invasive disease in recent reported cases. Knowledge about the pathogenicity and clinical presentation of this rare fungal infection will alert the clinicians for instituting an early appropriate therapy leading to better outcomes. Key words: Mucormycosis, Subcutaneous mucormycosis,Syncephalastrum racemosum
Introduction Mucormycosis (Zygomycosis) represent a spectrum of emerging infections caused by ubiquitous fungal pathogens. S. racemosum is a fungus belonging to order Mucorales, which has very rarely been implicated in causing human disease. Less than 10 cases have been reported in medical literature. We report a case of an adult diabetic male who developed locally invasive cutaneous disease due to S. racemosum. Case Report A 45-year‑old male, a farmer, presented to us with *Corresponding author (email: Department of Internal Medicine (SM, GS), Department of Pathology (MKP), Department of Microbiology (SP), Maharaja Krishna Chandra Gajapati Medical College, Berhampur, Odisha, India. Received: 03-09-2013 Accepted: 06-02-2014
development of a swelling in anterior chest wall in the left side during a routine follow up. There was no history of fever, cough, haemoptysis, weight loss, headache, altered sensorium, nasal discharge, visual problem or vomiting. There was no history of any trauma to the affected site. His significant past history included an episode of diabetic ketoacidosis 2 months back, which was successfully managed at our unit. The patient was a diagnosed case of type 2 diabetes mellitus for past 1 year and was on oral hypoglycaemic drugs. Despite repeated advice, his adherence to medication was poor. The patient was normotensive. There was no history of tuberculosis in the past. On examination, the patient was conscious and afebrile. He had a blood pressure of 130/80 mmHg and a respiratory rate of 16/min. There was no evidence of pallor, icterus, clubbing or lymphadenopathy. Systemic examination was unremarkable. There was a solitary swelling of about 3 × 2 cm in the left side of anterior chest wall. The
www.ijmm.org
October - December 2014
Case Reports
449
lesion was firm, non‑fluctuant, adherent to underlying fascia and was slightly tender. There were no local signs of inflammation or any evidence of necrotic tissue or discharging sinus. The swelling had developed gradually over a period of 1 month. His routine blood investigation including complete blood count, renal function test, liver function test, electrolyte panel all were within normal limit. Fasting and post‑prandial blood glucose levels were 160 and 240 mg/dl, respectively. He had a glycosylated haemoglobin level of 9% (normal
