Update on Actinomucor elegans, a mucormycete infrequently detected in human specimens: how combined microbiological tools contribute efficiently to a more accurate medical care

Int J Med Microbiol. 2017 Dec;307(8):435-442. doi: 10.1016/j.ijmm.2017.10.010. Epub 2017 Oct 26.

Abstract

Actinomucor elegans is a fungus belonging to mucormycetes and is still probably underdiagnosed due to misidentification. Based on a recent first case of Actinomucor elegans sinusitis in Europe, in an immunocompromised patient under voriconazole treatment, this paper aims to summarize knowledge about A. elegans mucormycoses. Even if the diagnosis of mucormycosis was made using traditional mycology techniques, precise identification of the fungus could only be achieved using molecular tools. In this observation, the galactomannan dosage was positive until the introduction of treatment and surgical debridement. The patient experienced no relapse after one year. By reviewing the four previous A. elegans reported cases and describing the mycological characteristics of this species, we highlight the need to use a combination of tools to improve the diagnostic strategy in such rare and life-threatening clinical situations.

Keywords: Actinomucor elegans; Galactomannan antigen; Mucormycosis; Polymerase chain reaction; Sinusitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antifungal Agents / administration & dosage
  • Debridement
  • Europe
  • Galactose / analogs & derivatives
  • Humans
  • Immunocompromised Host
  • Male
  • Mannans / blood
  • Mucorales / classification*
  • Mucorales / isolation & purification*
  • Mucormycosis / diagnosis*
  • Mucormycosis / microbiology*
  • Mucormycosis / pathology
  • Mucormycosis / therapy

Substances

  • Antifungal Agents
  • Mannans
  • galactomannan
  • Galactose