Intestinal mucormycosis in hemodialysis patients following deferoxamine

Area of Science:

• Mycology
• Nephrology
• Infectious Diseases

Background:

• Maintenance hemodialysis patients often require iron and aluminum chelation therapy.
• Deferoxamine is a commonly used chelator, but its potential role in opportunistic infections is a concern.

Observation:

• Two patients on maintenance hemodialysis developed mucormycosis while receiving deferoxamine.
• One patient also presented with pulmonary mucormycosis.
• These patients lacked typical risk factors like diabetes and acidosis but had underlying liver disease.

Findings:

• The study suggests a potential association between deferoxamine use and the development of mucormycosis.
• Liver disease may be a significant predisposing factor in this context.
• Siderophore activity of deferoxamine might promote fungal growth.

Implications:

• Clinicians should be aware of the risk of mucormycosis in hemodialysis patients treated with deferoxamine, especially those with liver disease.
• Further research is needed to elucidate the mechanisms by which deferoxamine may predispose to mucormycosis.
• Alternative chelation strategies or vigilant monitoring may be warranted for at-risk patients.