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Journal of Clinical Microbiology, February 2003, p. 783-788, Vol. 41, No. 2
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.2.783-788.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Apophysomyces elegans: an Emerging Zygomycete in India

A. Chakrabarti,1* A. Ghosh,1 G. S. Prasad,2 J. K. David,1 S. Gupta,1 A. Das,3 V. Sakhuja,4 N. K. Panda,5 S. K. Singh,6 S. Das,1 and T. Chakrabarti2

Departments of Medical Microbiology,1 Histopathology,3 Nephrology,4 Otolaryngology,5 Urology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012,6 Institute of Microbial Technology, Chandigarh 160036, India2

Received 12 July 2002/ Returned for modification 8 September 2002/ Accepted 3 November 2002

Apophysomyces elegans was considered a rare but medically important zygomycete. We analyzed the clinical records of eight patients from a single center in whom zygomycosis due to A. elegans was diagnosed over a span of 25 months. We also attempted a DNA-based method for rapid identification of the fungi and looked for interstrain polymorphism using microsattelite primers. Three patients had cutaneous and subcutaneous infections, three had isolated renal involvement, one had rhino-orbital tissue infection, and the final patient had a disseminated infection involving the spleen and kidney. Underlying illnesses were found in two patients, one with diabetes mellitus and the other with chronic alcoholism. A history of traumatic implantation was available for three patients. All except two of the patients responded to surgical and/or medical therapy; the diagnosis for the two exceptions was made at the terminal stage of infection. Restriction enzyme (MboI, MspI, HinfI) digestion of the PCR-amplified internal transcribed spacer region helped with the rapid and specific identification of A. elegans. The strains could be divided into two groups according to their patterns, with clustering into one pattern obtained by using microsatellite [(GTG)5 and (GAC)5] PCR fingerprinting. The study highlights the epidemiology, clinical spectrum, and diagnosis of emerging A. elegans infections.

* Corresponding author. Mailing address: Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. Phone: 91 172 711994. Fax: 91 172 744401. E-mail: chakrab{at}sancharnet.in.

Journal of Clinical Microbiology, February 2003, p. 783-788, Vol. 41, No. 2
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.2.783-788.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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