title: [Necrotising fasciitis caused by Saksenaea vasiformis in an immunocompetent patient after a car accident].
abstract: BACKGROUND
  Cutaneous mucormycosis (zygomycosis), with subcutaneous spreading and dissemination, in immunocompetent patients is an uncommon disease caused by species belonging to the fungal genera Apophysomyces, Rhizopus and Saksenaea, among others.
  
  
  METHODS
  A case of necrotising fasciitis by Saksenaea vasiformis in an immunocompetent woman is described. The infection was acquired through a car accident resulting in multiple injuries affecting mainly her right arm. After the surgical reduction of fractures, skin lesions worsened and led to necrosis. The patient quickly developed a severe necrotising fasciitis with negative cultures at first. Despite the extensive surgical debridement and the aggressive antifungal treatment, the patient died. The histopathological study showed a fungal infection due to a fungus belonging to the Mucorales order, which was confirmed by culturing the clinical sample on Sabouraud agar, and identifying the species by cultures on Czapek-Dox agar, and sequencing of the ITS region of the ribosomal DNA.
  
  
  CONCLUSIONS
  This case confirm the presence of this fungus in Spain, the value of histopathology for the mucormycosis diagnosis, as well as the need to perform special cultures to facilitate their isolation and identification to the species level by the combined use of Czapek-Dox agar and sequencing of the ITS region.
authors: Unitat d'Anatomia Patològica, Facultat de Medicina i Ciències de la Salut, IISPV, Universitat Rovira i Virgili, Reus, Tarragona, España.
authors: Emilio
authors: E
authors: Mayayo
authors: Alberto M
authors: AM
authors: Stchigel
authors: José F
authors: JF
authors: Cano
authors: Xana
authors: X
authors: Bernal-Escoté
authors: Josep
authors: J
authors: Guarro
mesh_terms: D000063:Accidents, Traffic; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001134:Arm Injuries / Q000150:complications* / Q000382:microbiology / Q000601:surgery; D001424:Bacterial Infections / Q000209:etiology; D060085:Coinfection; D003131:Combined Modality Therapy; D019115:Fasciitis, Necrotizing / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D005597:Fractures, Open / Q000382:microbiology / Q000601:surgery; D006801:Humans; D007121:Immunocompetence; D008875:Middle Aged; D009090:Mucorales / Q000187:drug effects / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification*; D009091:Mucormycosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D009104:Multiple Trauma; D009172:Mycology / Q000379:methods; D011885:Radius Fractures / Q000382:microbiology / Q000601:surgery; D012772:Shock, Septic / Q000209:etiology; D014946:Wound Infection / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery
chemical_list: D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B