Saksenaea vasiformis: a multifaceted approach to a complex case

Authors

  • Jessica E. Hanna Central Adelaide Local Health Network, South Australia, Australia https://orcid.org/0009-0008-3977-0359
  • Michael Bai Central Adelaide Local Health Network, South Australia, Australia
  • Gavin J. Carmichael The University of Adelaide, Adelaide, South Australia, Australia
  • Sarah E. Kidd Central Adelaide Local Health Network, South Australia, Australia; National Mycology Reference Centre, Microbiology and Infectious Diseases, SA Pathology, South Australia, Australia
  • Morgyn S. Warner National Mycology Reference Centre, Microbiology and Infectious Diseases, SA Pathology, South Australia, Australia
  • Shivangi Jog 1Central Adelaide Local Health Network, South Australia, Australia; The University of Adelaide, Adelaide, South Australia, Australia

DOI:

https://doi.org/10.18203/2349-2902.isj20254343

Keywords:

Saksenaea vasiformis infection, Mucormycosis, Surgical debridement, Wound infection

Abstract

Saksenaea vasiformis is a rare, opportunistic Mucorales fungus capable of causing rapidly progressive cutaneous and subcutaneous infections, including necrotising fasciitis. Early diagnosis is challenging due to its poor sporulation on routine media and often subtle initial clinical features. We describe a case of a soft-tissue infection in a co-morbid 75-year-old man from rural Australia with limited healthcare engagement. Despite broad-spectrum antibacterial therapy, operative intervention and negative-pressure wound-therapy, the wound continued to deteriorate. Eventually, sequencing of the internal transcribed spacer region confirmed S. vasiformis. The patient was commenced on liposomal amphotericin B followed by prolonged oral itraconazole due to underlying renal impairment and geographic barriers to ongoing inpatient care. This case underscores the need for early suspicion of atypical fungal pathogens in necrotic soft-tissue infections unresponsive to antibacterial therapy and highlights the importance of prompt surgical management, infectious diseases input, specialised fungal diagnostics and tailored antifungal treatment.

References

Saksena S. A new genus of the Mucorales. Mycologia. 1953;45(3):426-36.

Ajello L, Dean DF, Irwin RS. The zygomycete Saksenaea vasiformis as a pathogen of humans with a critical review of the etiology of zygomycosis. Mycologia. 1976;68(1):52-62.

Al-Hedaithy M. Cutaneous zygomycosis due to Saksenaea vasiformis: Case report and literature review. Ann Saudi Med. 1998;18(5):428-31.

Singh I, Kushwaha RKS. Biology and Significance of Saksenaea vasiformis. In: Satyanarayana T, Deshmukh SK, Johri BN, editors. Develop Fungal Biol Applied Mycol. 2017;19-28.

Gomes MZ, Lewis RE, Kontoyiannis DP. Mucormycosis caused by unusual mucormycetes, non-Rhizopus-Mucor, and-Lichtheimia species. Clin Microbiol Rev. 2011;24(2):411-45.

Andresen D, Donaldson A, Choo L, Knox A, Klaassen M, Ursic C, et al. Multifocal cutaneous mucormycosis complicating polymicrobial wound infections in a tsunami survivor from Sri Lanka. Lancet. 2005;365(9462):876-8.

Pourahmad M, Sepidkar A, Farokhnia MH, Tadayon SMK, Salehi H, Zabetian H. Mucormycosis after scorpion sting: case report. Mycoses. 2013;56(5):589-91.

Wilson PA. Zygomycosis due to Saksenaea vasiformis caused by a magpie peck. Med J Australia. 2008;189(9):521-2.

Bouza E, Muñoz P, Guinea J. Mucormycosis: an emerging disease? Clin Microbiol Infect. 2006;12:7-23.

Singh S, Kanaujia R, Kumar MB, Naga Santhosh Irrinki RN, Satish SN, Choudhary H, et al. Saksenaea vasiformis infection: Extensive abdominal wall necrotizing fasciitis with systematic review and analysis of 65 cases. Mycoses. 2023;66(8):697-704.

Pilch WT, Kinnear N, Hennessey DB. Saksenaea vasiformis infection in an immunocompetent patient in rural Australia. BMJ Case Rep. 2017;2017.

Gabriel A, Shores J, Bernstein B, de Leon J, Kamepalli R, Wolvos T, et al. A clinical review of infected wound treatment with Vacuum Assisted Closure (V.A.C.) therapy: experience and case series. Int Wound J. 2009;6:1-25.

Lohana P, Hogg FJ. Vacuum-assisted closure and primary cutaneous aspergillosis in a burn - a management dilemma! Ann Burns Fire Disasters. 2010;23(1):48-50.

Biermann N, Taeger CD, Schatz V, Eigenberger A, Prantl L, Felthaus O. The influence of negative pressure wound therapy on bacterial and fungal growth. J Tissue Viability. 2023;32(4):613-7.

Romo MA, Leach G, Reid CM, Dean RA, Suliman A. Infiltrating Wound Vacuum-Assisted Closure With Topical Amphotericin for Mucormycosis Infection of the Achilles Tendon. Fed Pract. 2023;40(2):47-9.

Salas V, Pastor FJ, Calvo E, Sutton D, García-Hermoso D, Mayayo E, et al. Experimental murine model of disseminated infection by Saksenaea vasiformis: successful treatment with posaconazole. Med Mycol. 2012;50(7):710-5.

Trotter DJ, Gonis G, Cottrill E, Coombs C. Disseminated Saksenaea vasiformis in an immunocompetent host. Med J Australia. 2008;189(9):519-20.

Sun QN, Fothergill AW, McCarthy DI, Rinaldi MG, Graybill JR. In vitro activities of posaconazole, itraconazole, voriconazole, amphotericin B, and fluconazole against 37 clinical isolates of zygomycetes. Antimicrob Agents Chemother. 2002;46(5):1581-2.

Lewis R, Niazi-Ali S, McIvor A, Kanj SS, Maertens J, Bassetti M, et al. Triazole antifungal drug interactions—practical considerations for excellent prescribing. J Antimicrob Chemother. 2024;79(6):1203-17.

Coronel-Pérez IM, Rodríguez-Rey EM, Castilla-Guerra L, Domínguez MC. Primary Cutaneous Mucormycosis Due to Saksenaea vasiformis in an Immunocompetent Patient. Actas Dermo-Sifiliográficas. 2015;106(6):516-8.

Sigera LSM, Gamage KKK, Jayawardena MN, Abeydeera WPH, Malkanthi MA, Jayasekera PI, et al. Cutaneous mucormycosis caused by Saksenaea vasiformis in a patient with systemic lupus erythematosus. Clin Case Rep. 2018;6(9):1730-4.

Planegger A, Uyulmaz S, Poskevicius A, Zbinden A, Müller NJ, Calcagni M. Cutaneous Invasive Fungal Infections with Saksenaea Species in Immunocompetent Patients in Europe: A Systematic Review and Case Report. Plast Reconstr Surg Glob Open. 2022;10(4):e4230.

Hammond SP, Bialek R, Milner DA, Petschnigg EM, Baden LR, Marty FM. Molecular methods to improve diagnosis and identification of mucormycosis. J Clin Microbiol. 2011;49(6):2151-3.

Tanphaichitr VS, Chaiprasert A, Suvatte V, Thasnakorn P. Subcutaneous mucormycosis caused by Saksenaea vasiformis in a thalassaemic child: first case report in Thailand. Mycoses. 1990;33(6):303-9.

Kaufman L, Padhye AA, Parker S. Rhinocerebral zygomycosis caused by Saksenaea vasiformis. J Med Vet Mycol. 1988;26(4):237-41.

Padhye AA, Ajello L. Simple method of inducing sporulation by Apophysomyces elegans and Saksenaea vasiformis. J Clin Microbiol. 1988;26(9):1861-3.

Lumyongsatien M, Jaru-Ampornpan P, Uiprasertkul M, Selva D. Orbital Infection by Saksenaea vasiformis in an Immunocompetent Host. Case Rep Ophthalmol Med. 2020;2020:8827074.

Bialek R, Zelck UE. PCR-based diagnosis of mucormycosis in tissue samples. Pathologe. 2013;34(6):511-8.

Lau A, Chen S, Sorrell T, Carter D, Malik R, Martin P, et al. Development and clinical application of a panfungal PCR assay to detect and identify fungal DNA in tissue specimens. J Clin Microbiol. 2007;45(2):380-5.

Meason-Smith C, Edwards EE, Older CE, Branco M, Bryan LK, Lawhon SD, et al. Panfungal Polymerase Chain Reaction for Identification of Fungal Pathogens in Formalin-Fixed Animal Tissues. Vet Pathol. 2017;54(4):640-8.

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Published

2025-12-30

How to Cite

Hanna, J. E., Bai, M., Carmichael, G. J., Kidd, S. E., Warner, M. S., & Jog, S. (2025). Saksenaea vasiformis: a multifaceted approach to a complex case . International Surgery Journal, 13(1), 142–146. https://doi.org/10.18203/2349-2902.isj20254343

Issue

Vol. 13 No. 1 (2026): January 2026

Section

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