title: Combat-Related Pythium aphanidermatum Invasive Wound Infection: Case Report and Discussion of Utility of Molecular Diagnostics.
abstract: We describe a 22-year-old soldier with 19% total body surface area burns, polytrauma, and sequence- and culture-confirmed Pythium aphanidermatum wound infection. Antemortem histopathology suggested disseminated Pythium infection, including brain involvement; however, postmortem PCR revealed Cunninghamella elegans, Lichtheimia corymbifera, and Saksenaea vasiformis coinfection. The utility of molecular diagnostics in invasive fungal infections is discussed.
authors.affiliation: San Antonio Military Medical Center, JBSA Fort Sam Houston, Texas, USA Aaron.r.farmer.mil@mail.mil.
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Farmer
authors.affiliation: San Antonio Military Medical Center, JBSA Fort Sam Houston, Texas, USA.
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
authors.affiliation: United States Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas, USA.
authors.forename: Ian R
authors.initials: IR
authors.lastname: Driscoll
authors.affiliation: Department of Microbiology and Immunology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Brian L
authors.initials: BL
authors.lastname: Wickes
authors.affiliation: Department of Pathology, Fungus Testing Laboratory University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Wiederhold
authors.affiliation: Department of Pathology, Fungus Testing Laboratory University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Deanna A
authors.initials: DA
authors.lastname: Sutton
authors.affiliation: Department of Pathology, Fungus Testing Laboratory University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
authors.forename: Carmita
authors.initials: C
authors.lastname: Sanders
authors.affiliation: San Antonio Military Medical Center, JBSA Fort Sam Houston, Texas, USA Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Katrin
authors.initials: K
authors.lastname: Mende
authors.affiliation: San Antonio Military Medical Center, JBSA Fort Sam Houston, Texas, USA.
authors.forename: Brent
authors.initials: B
authors.lastname: Enniss
authors.affiliation: Bexar County Medical Examiner's Office, San Antonio, Texas, USA.
authors.forename: James
authors.initials: J
authors.lastname: Feig
authors.affiliation: Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Ganesan
authors.affiliation: Landstuhl Regional Medical Center, Landstuhl, Germany.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Rini
authors.affiliation: San Antonio Military Medical Center, JBSA Fort Sam Houston, Texas, USA.
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Vento
mesh_terms: D000328:Adult; D001753:Blast Injuries; D054042:Bombs; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008889:Military Personnel; D025202:Molecular Diagnostic Techniques; D058968:Pythiosis; D011775:Pythium / Q000235:genetics / Q000302:isolation & purification; D014946:Wound Infection; D055815:Young Adult
references.citation: Surg Infect (Larchmt). 2014 Oct;15(5):521-6
references.pmid: 24821267
references.citation: J Clin Microbiol. 2006 May;44(5):1674-80
references.pmid: 16672392
references.citation: J Clin Microbiol. 2007 Feb;45(2):380-5
references.pmid: 17122000
references.citation: Clin Infect Dis. 2007 Apr 15;44(8):1078-83
references.pmid: 17366453
references.citation: Burns. 2007 May;33(3):341-6
references.pmid: 17321689
references.citation: J Antimicrob Chemother. 2007 Nov;60(5):1168-71
references.pmid: 17785281
references.citation: Clin Infect Dis. 2007 Dec 1;45(11):1479, 1522-4
references.pmid: 17990237
references.citation: Mycoses. 2008 Jul;51(4):275-90
references.pmid: 18331448
references.citation: Am J Clin Pathol. 2009 Mar;131(3):364-75
references.pmid: 19228642
references.citation: J Am Coll Surg. 2009 Mar;208(3):348-54
references.pmid: 19317995
references.citation: Antimicrob Agents Chemother. 2009 May;53(5):2136-8
references.pmid: 19289531
references.citation: Injury. 2009 May;40(5):548-54
references.pmid: 18656189
references.citation: J Clin Microbiol. 2010 Mar;48(3):741-52
references.pmid: 20042628
references.citation: Am J Clin Pathol. 2003 Jun;119(6):854-8
references.pmid: 12817433
references.citation: Mycol Res. 2003 May;107(Pt 5):537-44
references.pmid: 12884950
references.citation: Mycoses. 2004 Feb;47(1-2):14-23
references.pmid: 14998394
references.citation: Am J Med. 1989 Jan;86(1):115-7
references.pmid: 2642654
references.citation: Eur J Epidemiol. 1992 May;8(3):427-32
references.pmid: 1397206
references.citation: J Clin Microbiol. 1993 Nov;31(11):2967-73
references.pmid: 8263182
references.citation: Postgrad Med J. 1994 Aug;70(826):558-60
references.pmid: 7937448
references.citation: Clin Infect Dis. 1998 Dec;27(6):1388-93
references.pmid: 9868648
references.citation: Curr Microbiol. 2011 Apr;62(4):1225-9
references.pmid: 21188592
references.citation: Clin Infect Dis. 2005 Sep 1;41(5):634-53
references.pmid: 16080086
references.citation: Clin Microbiol Rev. 2011 Apr;24(2):247-80
references.pmid: 21482725
references.citation: Antimicrob Agents Chemother. 2011 Jul;55(7):3588-90
references.pmid: 21537028
references.citation: J Trauma. 2011 Jul;71(1 Suppl):S33-42
references.pmid: 21795875
references.citation: J Trauma. 2011 Jul;71(1 Suppl):S62-73
references.pmid: 21795880
references.citation: J Clin Microbiol. 2011 Oct;49(10):3710-3
references.pmid: 21813724
references.citation: J Clin Microbiol. 2011 Oct;49(10):3707-9
references.pmid: 21865421
references.citation: Vet Microbiol. 2012 May 25;157(1-2):137-42
references.pmid: 22209120
references.citation: Clin Infect Dis. 2012 Dec;55(11):1441-9
references.pmid: 23042971
references.citation: N Engl J Med. 2012 Dec 6;367(23):2214-25
references.pmid: 23215557
references.citation: J Antimicrob Chemother. 2014 Jun;69(6):1564-7
references.pmid: 24521855
references.citation: N Engl J Med. 2014 Jul 10;371(2):150-60
references.pmid: 25006721
references.citation: Clin Infect Dis. 2006 Sep 1;43(5):569-76
references.pmid: 16886148