Latest News Archive

Please select Category, Year, and then Month to display items
Previous Archive
28 August 2025 | Story André Damons | Photo André Damons
Dr Bonita van der Westhuizen
Dr Bonita van der Westhuizen, Senior lecturer and Pathologist in the UFS Department of Medical Microbiology, identified the first case of S. oblongispora mucormycosis in sub-Saharan Africa and among HIV-positive patients.

Medical staff at the University of the Free State (UFS) and the National Health Laboratory Service (NHLS) at the Universitas Academic Hospital have identified the first case of S. oblongispora mucormycosis in sub-Saharan Africa and among HIV-positive patients.

This discovery was made when a 32-year-old male patient was admitted to the Universitas Academic Hospital with right-sided facial swelling. The patient was HIV-positive, with a CD4 count of 50 cells/µl, and on antiretroviral therapy (ART), together with trimethoprim–sulfamethoxazole (TMX) prophylaxis. Additionally, he had hypertension for which he was also receiving treatment. The patient’s facial swelling rapidly progressed, with extension of redness and swelling observed daily.

Four days after admission, he underwent computerised tomography (CT) scan, and tissue biopsies were collected. The patient died three days later.

 

A significant discovery

Dr Bonita van der Westhuizen, Senior lecturer and Pathologist in the UFS Department of Medical Microbiology, who identified this rare fungus said this discovery is significant because it highlights the presence of this fungal pathogen in a region where it may have been previously unrecognised or underreported. It now raises awareness about the diversity of fungal infections affecting immunocompromised populations and underscores the need for improved diagnostics, surveillance, and treatment strategies in the region.

Dr Van der Westhuizen says though it is unclear where the deceased might have picked up this infection, moulds are ubiquitous in the environment. Patients usually get infected by inhalation of spores or traumatic implantation.

Together with colleagues Drs Liska Budding and Christie Esterhuysen, both from the UFS Department of Anatomical Pathology and the NHLS, and Prof Samantha Potgieter, Infectious disease expert in the UFS Department of Internal Medicine, Dr Van der Westhuizen published the case earlier this month (August) in the Journal Case Reports in Pathology.

 

Progresses rapidly

“Mucormycosis, which is caused by fungi in the order Mucorales, progresses rapidly due to a combination of factors related to the fungus, the host, and external influences. Mucorales fungi are known for their fast growth and ability to invade blood vessels. This allows the infection to spread quickly through the body, potentially reaching vital organs,” she says.

These fungi, Dr Van der Westhuizen explains, can resist being killed by immune cells, allowing them to establish infection. Some Mucorales fungi can produce toxins that disrupt blood vessels, further aiding the spread of the infection. Additionally, certain host conditions weaken the body's defences, allowing the infection to spread quickly.

“External factors that may play a role are traumatic injuries, endothelial damage and rarely hospital acquired infections. In essence, the aggressive nature of Mucorales fungi combined with weakened host defences and external factors creates a perfect storm for rapid disease progression in susceptible individuals.

“The Mucorales as a group normally infects patients with underlying risk factors including factors including diabetes mellitus, malignancies, transplant recipients, and current or past COVID-19 infection, however, this organism in particular, usually infects immunocompetent patients after traumatic inoculation,” says Dr Van der Westhuizen.

It is important to note, she continues, that all available data comes from research done in tropical regions. There is no data on this organism in sub-Saharan Africa which means it is still unknown what role this pathogen plays in our local patient population. The diagnostic complexities and rapid disease progression may contribute to the paucity of data in developing countries.

This infection can be treated with available antifungal agents, as well as surgical debridement of infected tissue. The challenge, however, is the rapid disease onset and progression to death. There is only a tiny window to help the patient. That is why clinical suspicion is so important, as immediate aggressive surgical debridement with antifungal agents is the only way to improve patient outcome. Unfortunately, this infection still has a high mortality rate, despite therapy.

 

Fungal diagnostics is complex

An invasive fungal infection (IFI) was not suspected in this patient, and he received neither antifungal therapy nor surgical interventions. His cause of death, likely the IFI, was only identified after he passed away and because of a combination of different testing platforms was used to identify this infection. Says Dr Van der Westhuizen: “This is unfortunately the case with mould infections as most readily available diagnostic methods lack sensitivity and these pathogens take long to grow in the laboratory. Fungal diagnostics is a specialised field that requires expertise. However, if clinicians are aware of these infections and they have an increased index of suspicion, appropriate therapy can be initiated even before the results are available.

“If clinicians suspect this type of infection early and they involve the infectious diseases physicians, microbiology and histopathology for support and advice, they will be guided to collect the most appropriate samples to ensure that an accurate diagnosis is made.”

There is a possibility that these infections had been missed before and even still today. Fungal diagnostics is a very complex field for various reasons. There is no highly sensitive stand-alone test to make a rapid diagnosis available. As newer methods are being developed and molecular diagnostics are advancing, fungal diagnostics are improving. A combination of testing platforms is still required to improve the sensitivity of diagnosing these infections.

Her hope for this research, says Dr Van der Westhuizen, who will now also embark further research into local fungal species for her PhD, their epidemiology, diagnostics, and their impact on vulnerable populations, ultimately contributing to better clinical care and health outcomes, is to advance understanding and awareness of Invasive mould infections specifically S. oblongispora, in sub-Saharan Africa and among HIV patients. She aims to improve early diagnosis, treatment strategies, and clinical outcomes, as well as to highlight the importance of monitoring fungal infections in immunocompromised populations. Additionally, her goal includes encouraging further research and collaboration in this area to better address fungal infections in the region.

News Archive

Position statement: Recent reporting in newspapers
2014-10-03

 

You may have read reports in two Afrikaans newspapers, regarding recent events at the University of the Free State (UFS). Sadly, those reports are inaccurate, one-sided, exaggerated and based not on facts, but on rumour, gossip and unusually personal attacks on members of the university management.

Anyone who spends 10 minutes on our Bloemfontein Campus would wonder what the so-called ‘crisis’ is about.

We are left with no choice other than to consider legal action, as well as the intervention of the South African Press Ombudsman, among other steps, to protect the good name of the institution and the reputation of its staff. No journalist has the right to launch personal and damaging attacks on a university and its personnel, whatever his or her motives, without being fair and factual. In this respect, the newspapers have a case to answer.

But here are the facts in relation to the reports:

  1. No staff member, whether junior or senior, is ever suspended without hard evidence in hand. Such actions are rare, and when done, are preceded by careful reviews of our Human Resource Policies, labour legislation and both internal and external legal advice. Then, and only then, is a suspension affected. A suspension, moreover, does not mean you are guilty and is a precautionary action to allow for the disciplinary investigation and process to be conducted, especially where there is a serious case to answer.
  2. At no stage was the Registrar instructed to leave the university; this is patently false and yet reported as fact. We specifically responded to the media that the Registrar does outstanding work for the university and that it is our intention for him to remain as our Registrar through the end of his contract in 2016.
  3. The Rector does not make decisions by himself. Senior persons, from the position of Dean, upwards, are appointed by statutory and other senior committees of the university and finally approved by Council. No rector can override the decision of a senior committee, and this has not happened at the UFS even in cases where the Rector serves as Chair of that committee. The impression of heavy-handed management at the top insults all our committee structures, including the Institutional Forum – the widest and most inclusive of stakeholder bodies at a university – which reports directly to Council on fairness and compliance of selection processes.
  4. In the case of senior appointments, Council makes the final decision. Council fully supports the actions taken on senior appointments, including a recent senior suspension. The fact that one Council member resigns just before the end of his term, whatever the real reason for this action, does not deter from the fact that the full Council in its last sitting approved the major staffing decisions brought before it. The image therefore that the two newspapers try to create of great turmoil and distress at the university, is completely unfounded.

Even if we wanted to, the university obviously cannot provide details about staffing decisions, especially disciplinary actions in process, since the rights of individuals should be protected in terms of the Human Resource Policies and procedures of the UFS. But that does not give any newspaper the right to speculate or state as fact that which is based on rumour or gossip, or to slander senior personnel of the university. For these reasons, we have been forced to seek legal remedy and correction as a matter of urgency.

Make no mistake, underlying much of the criticism of the university has been a distress about transformation at the UFS; in particular, the perception is created that white colleagues are losing their jobs. The evidence points in the opposite direction. Our progress with equity has been slow and we lag far behind most of the former white universities; that is a fact. More than 90% of our professors are white; most of our senior appointments at professorial level and as heads of department are still overwhelmingly white. Reasonable South Africans would agree that our transformation still has a long way to go and only the mean-spirited would contend otherwise. But based on the two Afrikaans newspaper reports, an impression is left of the aggressive rooting out of white colleagues.

In the past few years the academic standard of the university has significantly improved. We now have the highest academic pass rates in years, in part because we raised the academic standards for admission four years ago. We now have the highest rate of research publications, and among the highest national publication rate of scholarly books, in the history of the UFS. We have one of the most stable financial situations of any university in South Africa, with a strong balance sheet and growing financial reserves way beyond what we had before. We now attract top professors from around the country and other parts of the world, and we have the highest number of rated researchers, through the National Research Foundation, than ever before. And after the constant turmoil of a number of years ago, we now have one of the most stable campuses in South Africa. Those are the facts.

The UFS is also regarded around the world as a university that has become a model of transformation and reconciliation in the student body. The elections of our Student Representative Council are only the most visible example of how far we have come in our leadership diversity. Not a week goes by in which other universities, nationally and abroad, do not come to Kovsies to consult with us on how they can learn from us and deepen their own transformations, especially among students.

Rather than focus on what more than one senior journalist, in reference to the article in Rapport of 21 September 2014, rightly called ‘a hatchet job’ on persons and the university, here are the objective findings of a recent survey of UFS stakeholders: 92% endorse our values; 77% agree with our transformation; 78% believe we are inclusive; and 78% applaud our overall reputation index.  Those are very different numbers from a few years ago when the institution was in crisis.

This is our commitment to all our stakeholders: we will continue our model of inclusive transformation which provides opportunities for study and for employment for all South Africans, including international students and colleagues. We remain committed to our parallel-medium instruction in which Afrikaans remains a language of instruction; we are in fact the only medical school in the country that offers dual education and training in both Afrikaans and English for our students - not only English. We provide bursaries and overseas study opportunities to all our students, irrespective of race. And our ‘future professors’ programme is richly diverse as we seek the academic stars of the future.

We are not perfect as a university management or community. Where we make mistakes, we acknowledge them and try to do better the next time round. But we remain steadfast in our goal of making the UFS a top world university in its academic ambitions and its human commitments.

END

We use cookies to make interactions with our websites and services easy and meaningful. To better understand how they are used, read more about the UFS cookie policy. By continuing to use this site you are giving us your consent to do this.

Accept