A Rare case of Aggressive Cutaneous Zygomycosis Caused by Apophysomyces Variabilis

Abstract

Necrotizing fasciitis is a life-threatening soft tissue infection that can be caused by various bacterial and fungal pathogens. Among the fungal etiologies, mucormycosis typically associated with several species such as Mucor, Rhizopus, and Lichtheimia. However, the infection is caused by Apophysomyces spp., particularly Apophysomyces variabilis that are rare but increasingly reported in tropical regions, including India. Here, we report a case of a 59-year-old diabetic female who developed necrotizing fasciitis on her face following minor trauma. Initially, she was managed with antibiotics and surgical debridement. However, subsequent identification of Apophysomyces variabilis necessitated an adjustment in her treatment regimen to include Posaconazole. As a result of this adjustment, along with ongoing surgical debridement and antifungal therapy, the patient achieved successful wound healing and subsequently underwent skin grafting. In this report, we highlights the diagnostic challenges associated with Apophysomyces infections and emphasizes the critical importance of early recognition and targeted therapy to enhance patient outcomes.