Mucormycosis of the renal allograft: case report and review of the literature

被引:47
作者
Chkhotua, A
Yussim, A
Tovar, A
Weinberger, M
Sobolev, V
Bar-Nathan, N
Shaharabani, E
Shapira, Z
Mor, E
机构
[1] Rabin Med Ctr, Dept Transplantat, IL-49100 Petah Tiqwa, Israel
[2] Rabin Med Ctr, Inst Pathol & Internal Med C, IL-49100 Petah Tiqwa, Israel
[3] Rabin Med Ctr, Inst Infect Dis, IL-49100 Petah Tiqwa, Israel
关键词
kidney transplantation; living donor; mycophenolate mofetil;
D O I
10.1007/s001470100010
中图分类号
R61 [外科手术学];
学科分类号
摘要
Fungal infection is an uncommon complication after renal transplantation. We describe a rare form of mucormycosis in the renal graft. Our method was to review chart data and to perform medline searches. The patient was a 42-year-old man who underwent living-unrelated kidney transplantation in Egypt and returned to Israel on POD 8. Within the ensuing 4 weeks he experienced acute rejection which responded to treatment with steroids. Few days after discharge he was readmitted because of fever and graft dysfunction. An infected large perigraft collection was drained, but the patient became anuric and septic. Kidney biopsy showed infarcted necrotic tissue infiltrated by fungi which grew Mucor species. Despite initial improvement following graft nephrectomy and antifungal treatment the patient died of sepsis. Literature review revealed only three additional cases of graft infection due to Mucorales. We conclude that Renal graft infection due to Mucorales is an extremely rare and potentially lethal complication. Living unrelated donation in third world countries might be a possible risk factor. Fungal colonization may occur during transplantation. A high index of suspicion, leading to early diagnosis and initiation of antifungal treatment, in addition to graft nephrectomy, are keys to a more favorable outcome.
引用
收藏
页码:438 / 441
页数:4
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