Infectious cases have been reported globally in locations including the Americas, Southeast Asia, India, and Australia.

[5] Since the new species have only recently been recognized, much remains to be learned about their relative clinical importance, comparative virulence, epidemiology, and anti-fungal drug susceptibilities.

[1] Apophysomyces variabilis (CBS 658.93; FMR 10381 Archived 2016-03-04 at the Wayback Machine) was first identified by Alvarez et al. in 2010 from a human osteomyelitis patient in the Netherlands Antilles.

As well, carbon fixation ability aided in species differentiation with only A. elegans strains being able to assimilate the glycoside esculin.

[6] Though the majority of A. variabilis infections have been reported from India, the fungus has also been found in North and South America, Australia, and Southeast Asia.

[4] Unlike most members of the Mucorales, Apophysomyces species often fail to sporulate under standard clinical laboratory culture conditions.

[2] Colonies grow rapidly at 37 °C on CZA and initially appear white and woolly becoming greyish brown with age.

[2][9] Apophysomyces species cause infections of the skin and soft-tissue following injuries such as burns, automotive accidents, surgeries, and injections both intramuscular and subcutaneous.

[7] Successful treatment depends on early detection of infection, surgical debridement of necrotic tissues, and anti-fungal therapy with drugs such as posaconazole and amphotericin B.

[2][9] Any penetrating injury that breaks the skin barrier including; burns, injections, intravenous catheterization, and surgical wounds creates risk for developing mucormycosis.

[9] Treatment of A. variabilis infections usually involves aggressive antifungal therapy and often surgical removal of necrotic tissue.

In the mouse study, both drugs decreased the amount of hyphae in infected tissues but posaconazole had better survival outcomes than amphotericin B.

[5] In vitro antifungal susceptibility tests of the entire genus Apophysomyces have revealed that amphotericin B and posaconazole are the most effective against A. variabilis infections when compared to itraconazole, ravuconazole, and voriconazole.

Testing data has also showed that caspofungin and anidulafungin are inactive antifungal agents against all strains of the genus Apophysomyces.

This is mainly due to the lack of properly preserved isolates from clinical cases and the necessity of genetic analyses for species determination.