Fatal Cutaneous Mucormycosis After Kidney Transplant Publisher Pubmed



Davuodi S¹ ; Manshadi SAD¹ ; Salehi MR¹ ; Yazdi F¹ ; Khazravi M¹ ; Fazli JT² Show Affiliations
Source: Experimental and Clinical Transplantation Published:2015

Abstract

Mucormycosis is an uncommon opportunistic infection that is caused by Mucorales from the Zygomycetes class. Patients with severe immunodeficiency admitted to the hospital are at greatest risk for developing this infection. Mucormycosis usually is transmitted in humans by inhalation or inoculation of spores in the skin or mucous membranes. A 66-year-old man developed a surgical wound infection at 1 week after kidney transplant that did not improve despite broad-spectrum antibiotics and debridement. He was transferred to our hospital 45 days after transplant and had fever and a large purulent wound that was surrounded by a black necrotizing margin. Immunosuppressive drugs were discontinued and the dosage of prednisolone was decreased. Massive debridement was performed but was incomplete because he had full-thickness abdominal wall necrosis. Histopathology showed broad fungal hyphae without septation, consistent with the diagnosis of mucormycosis. Despite antifungal therapy with amphotericin B and additional debridement, the patient died of septic shock at 52 days after kidney transplant. Cutaneous fungal infections should be considered in the differential diagnosis of any nonhealing infected wound that does not respond to broadspectrum antibiotics, especially in patients with predisposing risk factors such as transplant. © Baskent University 2015 Printed in Turkey. All Rights Reserved.