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Gastric Mucormycosis in a Liver and Kidney Transplant Recipient: Case Report and Concise Review of Literature.

Abstract：

:Mucormycosis is an uncommonly encountered fungal infection in solid organ transplantation. The infection is severe and often results in a fatal outcome. The most common presentations are rhino-sino-orbital and pulmonary disease. We describe a rare case of gastric mucormycosis in a patient with a combined liver-kidney transplant affected by glycogen storage disease type Ia. A 42-year-old female patient presented with gastric pain and melena 26 days after transplantation. Evaluation with upper endoscopy showed two bleeding gastric ulcers. Histological examination of gastric specimens revealed fungal hyphae with evidence of Mucormycetes at subsequent molecular analysis. Immunosuppressive therapy was reduced and antifungal therapy consisting of liposomal amphotericin B and posaconazole was promptly introduced. Gastrointestinal side effects of posaconazole and acute T-cell rejection of renal graft complicated management of the case. A prolonged course of daily injections of amphotericin B together with a slight increase of immunosuppression favored successful treatment of mucormycosis as well as of graft rejection. At 2-year follow-up, the woman was found to have maintained normal renal and liver function. We conclude that judicious personalization of antimicrobial and antirejection therapy should be considered to resolve every life-threatening case of mucormycosis in solid organ transplantation.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Alfano G,Fontana F,Francesca D,Assirati G,Magistri P,Tarantino G,Ballarin R,Rossi G,Franceschini E,Codeluppi M,Guaraldi G,Mussini C,Di Benedetto F,Cappelli G

doi

10.1016/j.transproceed.2017.11.036

subject

Has Abstract

pub_date

2018-04-01 00:00:00

pages

905-909

issue

3

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(17)30873-4

journal_volume

50

pub_type

杂志文章,评审

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