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Pulmonary mucormycosis in diabetic renal allograft recipients
S Latif1, N Saffarian, K Bellovich
1Department of Internal Medicine, St John Hospital and Medical Center, Detroit, MI 48236, USA.
Abstract:
Renal allograft recipients are prone to opportunistic infections due to their need of immunosuppression to prevent rejection. Mucormycosis is a rare opportunistic infection caused by a fungi of the order Mucorales. Risk factors predisposing to this disease include prolonged neutropenia, chelation therapy for iron or aluminum overdose, diabetes, and patients who are immunosuppressed. Life-threatening infections can occur, as this fungi has the propensity to invade blood vessel endothelium, resulting in hematologic dissemination. Early diagnosis and prompt aggressive therapy is imperative to achieve an improved outcome. We present two cases of pulmonary mucormycosis in diabetic renal allograft recipients who were treated successfully with amphotericin B and surgical resection of the lesions with preservation of their allograft function. In this era of intensified immunosuppression, we may see an increased incidence of mucormycosis in our transplant population.
Insights
Renal transplant patients on immunosuppression face risks of mucormycosis, a fungal infection. Early treatment with amphotericin B and surgery improved outcomes in two diabetic patients, preserving kidney function.
Area of Science:
- Mycology
- Transplant Medicine
- Infectious Diseases
Background:
- Renal allograft recipients require immunosuppression, increasing susceptibility to opportunistic infections.
- Mucormycosis, a rare fungal infection caused by Mucorales, poses a life-threatening risk due to vascular invasion and dissemination.
- Risk factors include diabetes, neutropenia, and iron/aluminum chelation therapy.
Observation:
- Two cases of pulmonary mucormycosis in diabetic renal allograft recipients are presented.
- Patients presented with opportunistic fungal infections post-transplantation.
Findings:
- Successful treatment involved amphotericin B and surgical resection of lesions.
- Allograft function was preserved following treatment.
- Prompt diagnosis and aggressive therapy are crucial for improved outcomes.
Implications:
- Increased incidence of mucormycosis may be observed in transplant populations due to intensified immunosuppression.
- This highlights the importance of vigilance for mucormycosis in immunocompromised patients.
- Aggressive management strategies are vital for managing this severe opportunistic infection in transplant recipients.