Doctors at the University of the Free State (UFS) and the National Health Laboratory Service (NHLS) at the Universitas Academic Hospital have confirmed the first recorded case of S. oblongispora mucormycosis in sub-Saharan Africa. It is also the first time the rare and deadly fungal infection has been identified in an HIV-positive patient in the region.

The case involved a 32-year-old man living with HIV who was admitted to Universitas Academic Hospital with severe swelling on the right side of his face. Despite being on antiretroviral therapy and treatment for hypertension, his condition worsened rapidly. Four days after admission, a CT scan and tissue biopsies were conducted. He died three days later, before a diagnosis could be confirmed.

Landmark discovery

Dr. Bonita van der Westhuizen, Senior Lecturer and Pathologist in the UFS Department of Medical Microbiology, described the discovery as a critical turning point for public health in the region.

“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,” she said in a media statement sent to EdPublica.

The case report, co-authored with Drs. Liska Budding and Christie Esterhuysen from the UFS/NHLS and Prof. Samantha Potgieter from the UFS Department of Internal Medicine, was published in Case Reports in Pathology last month.

Rapid and aggressive disease

Mucormycosis, caused by fungi from the order Mucorales, is known for its speed and severity. The infection can invade blood vessels, spread to vital organs, and resist the body’s immune defences.

“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,” Dr. Van der Westhuizen explained in the statement. She added that external factors such as traumatic injuries or hospital-acquired infections can worsen the disease’s progression.

While mucormycosis usually strikes patients with underlying conditions like diabetes, cancer, or organ transplants, S. oblongispora has often been linked to infections in otherwise healthy individuals after traumatic inoculation. The lack of local data, however, means its prevalence in African populations remains unclear.

Diagnostic hurdles

In this case, invasive fungal infection was not initially suspected, and the patient did not receive antifungal medication or surgical treatment. The diagnosis was confirmed only after his death, highlighting the broader challenges of detecting fungal diseases in resource-limited settings.

“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,” Dr. Van der Westhuizen said. “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.”

Experts warn that even with antifungal drugs and surgical removal of infected tissue, the window for treatment is narrow and survival rates remain low.

Building awareness and research

Dr. Van der Westhuizen is continuing her research on invasive mould infections as part of her PhD, focusing on fungal epidemiology and its impact on vulnerable groups such as HIV patients.

Her goal, she said in the media statement, is “to advance understanding and awareness of invasive mould infections, specifically S. oblongispora, in sub-Saharan Africa and among HIV patients. I aim to improve early diagnosis, treatment strategies, and clinical outcomes, as well as to highlight the importance of monitoring fungal infections in immunocompromised populations.”

She hopes the findings will spur more regional collaboration and investment in fungal diagnostics — an often overlooked but increasingly urgent frontier in infectious disease research.

Our immune system’s largest antibody, IgM, has revealed a hidden superpower — it doesn’t just latch onto harmful microbes, it can also act like a brace, mechanically stabilizing bacterial toxins and stopping them from wreaking havoc inside our bodies.

A team of scientists from the S.N. Bose National Centre for Basic Sciences (SNBNCBS) in Kolkata, India, an autonomous institute under the Department of Science and Technology (DST), made this discovery in a recent study. The team reports that IgM can mechanically stiffen bacterial proteins, preventing them from unfolding or losing shape under physical stress.

“This changes the way we think about antibodies,” the researchers said in a media statement. “Traditionally, antibodies are seen as chemical keys that unlock and disable pathogens. But we show they can also serve as mechanical engineers, altering the physical properties of proteins to protect human cells.”

Unlocking a new antibody role

Our immune system produces many different antibodies, each with a distinct function. IgM, the largest and one of the very first antibodies generated when our body detects an infection, has long been recognized for its front-line defense role. But until now, little was known about its ability to physically stabilize dangerous bacterial proteins.

The SNBNCBS study focused on Protein L, a molecule produced by Finegoldia magna. This bacterium is generally harmless but can become pathogenic in certain situations. Protein L acts as a “superantigen,” binding to parts of antibodies in unusual ways and interfering with immune responses.

Using single-molecule force spectroscopy — a high-precision method that applies minuscule forces to individual molecules — the researchers discovered that when IgM binds Protein L, the bacterial protein becomes more resistant to mechanical stress. In effect, IgM braces the molecule, preventing it from unfolding under physiological forces, such as those exerted by blood flow or immune cell pressure.

Why size matters

The stabilizing effect depended on IgM concentration: more IgM meant stronger resistance. Simulations showed that this is because IgM’s large structure carries multiple binding sites, allowing it to clamp onto Protein L at several locations simultaneously. Smaller antibodies lack this kind of stabilizing network.

“This synergistic bracing action gives IgM a unique advantage in neutralizing bacterial toxins that are exposed to mechanical forces inside the body,” the researchers explained.

The finding highlights an overlooked dimension of how our immune system works — antibodies don’t merely bind chemically but can also act as mechanical modulators, physically disarming toxins.

Such insights could open a new frontier in drug development, where future therapies may involve engineering antibodies to stiffen harmful proteins, effectively locking them in a harmless state.

The study suggests that by harnessing this natural bracing mechanism, scientists may be able to design innovative treatments that go beyond traditional antibody functions.

The University of the Free State (UFS), South Africa, and Universitas Academic Hospital have achieved a global healthcare milestone by becoming the first clinical site worldwide to successfully integrate artificial intelligence into cancer treatment planning, marking a transformative advancement in oncology care, according to a statement issued by UFS.

AI implementation

The Departments of Medical Physics and Oncology at UFS, in partnership with Universitas Academic Hospital, have implemented the Radiation Planning Assistant (RPA), a sophisticated web-based AI platform developed by MD Anderson Cancer Center in Houston, Texas. This pioneering initiative has already treated nearly 50 patients, positioning the Bloemfontein-based teams as global leaders in the clinical application of AI in radiotherapy.

Under the leadership of Dr. William Shaw, Senior Lecturer and Deputy Manager in the Department of Medical Physics, the institution has built a robust academic partnership with Professor Laurence Court and his team at MD Anderson Cancer Center—a collaboration that is now yielding remarkable real-world results.

“The introduction and clinical integration of the RPA at the UFS and Universitas Hospital represents a major advancement for oncology services—both regionally and nationally,” Dr. Shaw explained. “It signifies the transition from research collaboration to real-world application, where artificial intelligence is being used to improve access to safe, high-quality cancer care.”

Revolutionizing treatment planning

The RPA technology addresses one of the most time-consuming aspects of cancer care: creating patient-specific radiation treatment plans. The cloud-based platform automates critical components of the treatment planning process, enabling consistent production of high-quality radiotherapy plans while reducing demands on specialized clinical staff.

Dr. Shaw described the streamlined process: “The process begins with the acquisition of a planning CT scan, which serves as the sole imaging input to the RPA. Once the CT dataset has been captured, it is uploaded to the RPA platform via a secure web interface.”

The system uses advanced machine learning algorithms to automatically identify and delineate both tumour volumes and critical normal tissues. Following the completion of the contouring process, the platform automatically generates a comprehensive radiotherapy treatment plan.

Expanding treatment applications

Initially implemented for cervix cancer treatment—representing the largest proportion of radiotherapy patients at the institution—the RPA has since expanded to encompass breast cancer, head and neck cancers, and primary brain tumors. With ongoing institutional support, the system shows significant promise for broader application across nearly all major tumor types treated with external beam radiotherapy.

Professor Vasu Reddy, Deputy Vice-Chancellor for Research and Internationalisation at UFS, praised the achievement: “We extend our congratulations to our colleagues for their exemplary collaborative achievements. Your pioneering work represents the transformative power of multidisciplinary research in advancing medical science and improving patient outcomes.”

Immediate patient benefits

The technology delivers immediate, meaningful improvements for cancer patients by enabling faster access to well-constructed, evidence-based treatment plans reviewed and refined by experts. This translates to more timely care, fewer unplanned treatment interruptions, and improved protection of normal tissues, resulting in fewer side effects and better overall outcomes.

“Our aim is to use artificial intelligence not as a shortcut, but as a tool to standardize, scale, and improve cancer care in places where the need is greatest,” Dr. Shaw emphasized. “The RPA enhances the quality, consistency, and timeliness of cancer treatment in radiotherapy settings—particularly in environments where clinical capacity is limited.”

International expansion

The success in Bloemfontein serves as a model for broader health system innovation, providing a foundation for the safe, phased rollout of similar systems in other provinces. Professor Court has already extended access to the RPA to other radiotherapy centers in South Africa, with expansion to additional countries planned for the near future.

The Department of Oncology, led by Professor Alicia Sherriff, has joined the initiative as an active clinical partner, establishing a multi-disciplinary collaboration that lays the foundation for further research and innovation at the intersection of medical physics, oncology, and data science.

Advanced treatment techniques

Beyond external beam radiotherapy, the UFS and Universitas teams are advancing the use of interstitial brachytherapy for cervix cancer. While not the first globally to implement this specialized technique, the Bloemfontein team ranks among the earliest adopters on the African continent, helping expand access to this advanced modality where it’s most needed.

Future vision

This work received support from the Nuclear Technologies in Medicine and the Biosciences Initiative (NTeMBI), a national technology platform developed and managed by the South African Nuclear Energy Corporation (Necsa) and funded by the Technology Innovation Agency (TIA).

Dr. Shaw’s team has played a central role in developing safe, reliable clinical processes to integrate AI tools like the RPA into daily practice, ensuring that automation enhances rather than replaces professional expertise.

Professor Reddy outlined the broader vision, “The future we are heading towards is one where human innovation and digital technologies work together to elevate the standard of care, rather than replace humanity in medicine. It is encouraging to see how our colleagues are internationalizing our footprint, together with machine precision to enhance detection, personalize treatment and, perhaps importantly, empowering clinicians with data-driven insights for patient care.”

This innovation represents a significant step forward for cancer care in South Africa and demonstrates how international partnerships can bring cutting-edge technologies to healthcare frontlines, making them work effectively in real clinics for real patients. As cancer incidence rises across low- and middle-income countries, the leadership shown by the UFS and Universitas teams offers a compelling model for how academic medical centers can respond with agility, scientific rigor, and global solidarity.

Edited by Chris Jose