Combat-Related Pythium aphanidermatum Invasive Wound Infection: Case Report and Discussion of Utility of Molecular Diagnostics

Aaron R Farmer; Clinton K Murray; Ian R Driscoll; Brian L Wickes; Nathan Wiederhold; Deanna A Sutton; Carmita Sanders; Katrin Mende; Brent Enniss; James Feig; Anuradha Ganesan; Elizabeth A Rini; Todd J Vento

doi:10.1128/JCM.00410-15

Combat-Related Pythium aphanidermatum Invasive Wound Infection: Case Report and Discussion of Utility of Molecular Diagnostics

J Clin Microbiol. 2015 Jun;53(6):1968-75. doi: 10.1128/JCM.00410-15. Epub 2015 Apr 1.

Authors

Affiliations

¹ San Antonio Military Medical Center, JBSA Fort Sam Houston, Texas, USA [email protected].
² San Antonio Military Medical Center, JBSA Fort Sam Houston, Texas, USA.
³ United States Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas, USA.
⁴ Department of Microbiology and Immunology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
⁵ Department of Pathology, Fungus Testing Laboratory University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
⁶ San Antonio Military Medical Center, JBSA Fort Sam Houston, Texas, USA Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
⁷ Bexar County Medical Examiner's Office, San Antonio, Texas, USA.
⁸ Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
⁹ Landstuhl Regional Medical Center, Landstuhl, Germany.

Abstract

We describe a 22-year-old soldier with 19% total body surface area burns, polytrauma, and sequence- and culture-confirmed Pythium aphanidermatum wound infection. Antemortem histopathology suggested disseminated Pythium infection, including brain involvement; however, postmortem PCR revealed Cunninghamella elegans, Lichtheimia corymbifera, and Saksenaea vasiformis coinfection. The utility of molecular diagnostics in invasive fungal infections is discussed.

Publication types

Case Reports
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Blast Injuries*
Bombs
Fatal Outcome
Humans
Male
Military Personnel*
Molecular Diagnostic Techniques
Pythiosis*
Pythium* / genetics
Pythium* / isolation & purification
Wound Infection*
Young Adult