Volume 113, Issue 4, December 2025, 117054Author links open overlay panel, , , , , Abstract

Syncephalastrum species belonging to the order mucorales are predominantly associated with onychomycosis, cutaneous infections and rhino-orbital mucormycosis. The surge of syncephalstrum causing invasive infections in immunocompromised patients has been reported in widely separated locations. This case report documents the isolation of Syncephalastrum from acute gangrenous cholecystitis (GC) in a young immunocompetent individual, an uncommon presentation that underscores the need for heightened clinical awareness and diagnostic precision.

Introduction

Syncephalstrum species are ubiquitous in the environment and are generally considered to have low pathogenic potential in immunocompetent hosts. However, they can cause opportunistic invasive infections in Immunocompromised or debilitated individuals. The possibility of Syncephalastrum as an aetiological agent should be considered when it is isolated from normally sterile sites, particularly when microscopy, culture and histopathology findings are concordant [1]. Penetrating trauma with direct inoculation of fungal spores is the most common mode of transmission, often leading to localized necrosis or deep-seated infections. Dissemination is rare in individuals without severe underlying conditions [2]. To the best of our knowledge this is the first report documenting the isolation of Syncephalastrum from a case of necrotizing gangrenous cholecystitis in a patient with no co morbid conditions.

Section snippetsCase report

A 28 year old female presented to the outpatient department with complaints of severe colicky pain in the right quadrant of the abdomen. The pain was intermittent radiating to the back and had persisted for more than three days. She complained of nausea and multiple episodes of vomiting. On examination, she had high grade fever and tachycardic with a pulse rate of 120 bpm. She was dehydrated and hypobolemic with a blood pressure of 90/60mm Hg. Abdominal examination revealed severe tenderness in

Discussion

Gangrenous cholecystitis (GC) develops as a complication in 2- 20 % of cases of acute cholecystitis. The progression of Inflammation and ischemia in the gall bladder wall typically worsens with age due to declining vascular integrity [3]. However, in this case, the patient was in her late twenties, suggesting that the observed ischemia and inflammation could be attributed to fungal infection rather than age related vascular insufficiency. Skiada et al. reported that mucorales including

Source of Funding

None.

Patient Consent

Written informed Consent was received from the patient.

CRediT authorship contribution statement

V. Mullai: Writing – original draft, Validation, Methodology. C․S Sripriya: Supervision. M. Sharmal Kumar: Methodology, Validation. D. Devendiren: Investigation, Data curation. V. Ishwarya: Investigation, Data curation. M. Shobana: Resources.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgement

We Acknowledge Dr.Srinivasaraman, Anderson Diagnostics for his support, Dr.Shobana, Surgeon, Prashant Hospitals for getting patient consent and the case history.

References (5)

There are more references available in the full text version of this article.

View full text

© 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.