Fatal Actinomucor elegans var. kuwaitiensis infection following combat trauma

Abstract

We report the first case of invasive mucormycosis secondary to Actinomucor elegans infection. A severely injured soldier with a fatal A. elegans var. kuwaitiensis infection is described. The identification of this fungus was performed by classical and molecular methods, and this report documents the pathogenicity of the recently described variety Actinomucor elegans var. kuwaitiensis.

FIG. 1.

Gomori methenamine silver stain of necrotic intra-abdominal muscle showing invasive, ribbon-like, branching fungal elements characteristic of members of Mucorales species together with budding yeasts characteristic of Candida species.

FIG. 2.

Verticillately branching sporangiophores, spiny, encrusted sporangia, and sporangiospores of Actinomucor elegans var. kuwaitiensis. Note secondary sporangiophores being formed beneath the septum on the primary sporangium.

FIG. 3.

Single sporangium and sporangiospores of Actinomucor elegans var. kuwaitiensis. Note the roughened area on the sporangiophore beneath the septum.

FIG. 4.

Verticillately branching sporangiophores, bare columella dislodged from the remainder of the sporangium, and variously sized smooth sporangiospores of Actinomucor elegans var. kuwaitiensis.