Severe skin and soft tissue pythiosis acquired in a hot spring in the southwestern United States, a case report and review of North American cases

Travel Med Infect Dis. 2022 Jul-Aug:48:102349. doi: 10.1016/j.tmaid.2022.102349. Epub 2022 Apr 29.

Abstract

Background: Human pythiosis, caused primarily by the aquatic oomycete, Pythium insidiosum, is an emerging but uncommon infection in North America. The infection is frequently life-threatening and is often initially unrecognized due to its rarity and similar presentation to certain fungal infections.

Methods: We report a case of skin and soft tissue pythiosis in a patient without significant underlying comorbidities acquired in a New Mexico hot spring and review its successful treatment. We also review all reported pythiosis cases in North America.

Results: Eleven confirmed cases of human pythiosis acquired in North America were identified. The majority of cases occurred in children (64%), ten of eleven cases were acquired in the southern U.S., Mexico, Central America or the Caribbean and four of the eleven individuals succumbed to the infection.

Conclusions: With recognition and aggressive surgical and medical treatment good clinical outcomes can be achieved when treating human pythiosis.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Child
  • Hot Springs*
  • Humans
  • North America
  • Pythiosis* / diagnosis
  • Pythiosis* / drug therapy
  • Pythiosis* / microbiology
  • Pythium*
  • Southwestern United States