P140 Saksenaea vasiformis infection: case report of extensive abdominal wall necrotizing fasciitis with systematic review and analysis of 64 cases

POSTER SESSION 2, SEPTEMBER 22, 2022, 12:30 PM - 1:30 PM: INTRODUCTION: Saksenaea vasiformis is a rarely reported Mucorales causing mucormycosis in both immunocompromised and immunocompetent individuals. Due to few reported cases, the clinical characteristics and optimal management strategy for this rare agent are not clearly described. Therefore, we conducted a combined analysis of a case of extensive abdominal wall necrotizing fasciitis from our center with individual patient data extracted from other reports in world literature to give an overview of clinical and demographic profiles as well as factors affecting outcomes in this rare infection. METHODS: We systematically reviewed Medline, Embase, and CINHAL for studies on S. vasiformis infections reported till January 1, 2022, and 57 studies (63 patients) were retrieved. We also describe clinical and demographic characteristics and outcomes of a case of extensive abdominal wall necrotizing fasciitis managed at our institution. RESULTS: Of the 64 included cases, the majority were reported from India (26.6%). The most common risk factors for infection were accidental trauma (31.3%), health-care-related wounds (14.1%), and animal/insect bites (12.5%). Subcutaneous infection was the most common clinical presentation (60.9%) followed by rhino-orbito-cerebral mucormycosis (ROCM) (14%), necrotizing fasciitis (10%), and disseminated infection (9.3%), pulmonary (3.2%) and osteomyelitis (1.6%). Mortality was observed in 24 (37.5%) patients and healthcare-related injuries were significantly associated with higher mortality (P .001). The use of posaconazole (P .019) and surgical intervention (P: .032) was associated with significantly better survival. See Figures 1 and 2 below. DISCUSSION: In this study, we describe the largest compendium of mucormycosis due to S. vasiformis and can be useful in increasing awareness regarding this rare Mucorales in addition to guiding patient management.