In recent times, improved diagnostic techniques have revealed an alarming number of cases of mucormycosis in immunocompetent individuals. The Saksenaea species, is a rare cause of mucormycosis, and is often associated with skin and subcutaneous infection due to trauma in both immunocompromised and immunocompetent subjects. The purpose of this study was therefore, through a review of the literature, to investigate the problem of infections caused by Saksenaea Erythrospora, evaluating the clinical manifestations of the infection, the triggering factors, the therapies and patients’ outcomes.
A research of peer-reviewed literature in the electronic databases MEDLINE (PubMed) and Scopus was conducted in the period June 2020-January 2021 using the key word "Saksenaea erythrospora". Studies in Italian, English, French, Spanish focused on cases of Saksenaea erythrospora were included, without time restrictions. Studies that provided ambiguous or insufficient data were excluded.
Bibliographic research yielded 23 publications; 7 were included in the review. The studies were published between 2011 and 2015 and involved a total of 11 patients of average age 37.9 years (SD 17.23) hospitalized in several hospitals in: USA, India, Argentina, Colombia, Thailand. 6 patients were women, 5 men. All patients had an almost normal immune status. The causes of the infection were: injections, traumas, surgery. Two patients, despite surgical and medical therapy, died.
In recent years, infections from new and rare species of fungi have been increasingly frequent, including serious necrotizing infections from Saksenaea erythrospora. Early identification and timely management are essential to reduce morbidity and mortality. A greater awareness and education about the risks deriving from carrying out surgical procedures abroad, especially in precarious hygiene situations, could be additional effective weapons to reduce the incidence of these infections.
2. Perlroth J, Choi B, Spellberg B. Nosocomial fungal infections: epidemiology, diagnosis, and treatment. Medical mycology. 2007;45(4):321-46.
3. Magaki S, Minasian T, Bork J, Harder SL, Deisch JK. Saksenaea infection masquerading as a brain tumor in an immunocompetent child. Neuropathology : official journal of the Japanese Society of Neuropathology. 2019;39(5):382-8.
4. Bunyada Putthirangsiwong PM, Weerawan Chokthaweesak, Dinesh Selva. Periocular Cutaneous Mucormycosis Caused by Saksenaea erythrospora. Journal of Pediatric Infectious Diseases 2019; 14(04): 209-212.
5. Chander J, Singla N, Kaur M, Punia RS, Attri A, Alastruey-Izquierdo A, et al. Saksenaea erythrospora, an emerging mucoralean fungus causing severe necrotizing skin and soft tissue infections - a study from a tertiary care hospital in north India(). Infectious diseases. 2017;49(3):170-7.
6. Hospenthal DR, Chung KK, Lairet K, Thompson EH, Guarro J, Renz EM, et al. Saksenaea erythrospora infection following combat trauma. Journal of clinical microbiology. 2011;49(10):3707-9.
7. Mukherjee B, Kundu D. Necrotizing fungal infection due to Saksenaea erythrospora: A case report and review of literature. Indian journal of ophthalmology. 2018;66(10):1513-6.
8. Relloso S, Romano V, Landaburu MF, Herrera F, Smayevsky J, Vecino C, et al. Saksenaea erythrospora infection following a serious sailing accident. Journal of medical microbiology. 2014;63(Pt 2):317-21.
9. Rodriguez JY, Rodriguez GJ, Morales-Lopez SE, Cantillo CE, Le Pape P, Alvarez-Moreno CA. Saksenaea erythrospora infection after medical tourism for esthetic breast augmentation surgery. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2016;49:107-10.
10. Uma Tendolkar AvD, Anagha Joshi,Jeroen Koomen, Renuka Bradoo, Sujata Baveja, Shailesh Agrawal. Rhinosinusitis caused by Saksenaea erythrospora in an immunocompetent patient in India: a first report. JMM Case Reports. 2015.
11. Muszewska A, Pawlowska J, Krzysciak P. Biology, systematics, and clinical manifestations of Zygomycota infections. European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology. 2014;33(8):1273-87.
12. Neil Lunt RS, Mark Exworthy, Stephen T. Green, Daniel Horsfall and Russell Mannion. Medical Tourism: Treatments, Markets and Health System Implications: A scoping review.
13. Pierini E, Pioppo M, Troiano G, Casucci P, Checconi O, Ruffini F, et al. Patient mobility for bone marrow transplant: the experience of the Perugia Hospital, years 2000-2013. Annali di igiene : medicina preventiva e di comunita. 2015;27(5):769-76.
14. Terzi E, Kern T, Kohnen T. [Complications after refractive surgery abroad]. Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 2008;105(5):474-9.
15. Canales MT, Kasiske BL, Rosenberg ME. Transplant tourism: Outcomes of United States residents who undergo kidney transplantation overseas. Transplantation. 2006;82(12):1658-61.
16. Jeevan R, Birch J, Armstrong AP. Travelling abroad for aesthetic surgery: Informing healthcare practitioners and providers while improving patient safety. Journal of plastic, reconstructive & aesthetic surgery : JPRAS. 2011;64(2):143-7.
17. Troiano G, Mercurio I, Nante N, Lancia M, Bacci M. Candida autovaccination: A new strategy to prevent antifungal resistance? Journal of infection prevention. 2018;19(4):201-2.
18. Napolitani M, Troiano G, Bedogni C, Messina G, Nante N. Kocuria kristinae: an emerging pathogen in medical practice. Journal of medical microbiology. 2019;68(11):1596-603.
19. Bougnoux ME, Brun S, Zahar JR. Healthcare-associated fungal outbreaks: New and uncommon species, New molecular tools for investigation and prevention. Antimicrobial resistance and infection control. 2018;7:45.