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Gastric perforation due to mucormycosis after heart-lung and heart transplantation
C Knoop1, M Antoine, J L Vachiéry
1Department of Chest Medicine, Erasme University Hospital, Brussels, Belgium.
Background:
Gastrointestinal complications are a well-documented source of morbidity and mortality after heart and lung transplantation.
Methods:
We report on two patients who presented with gastric perforation caused by mucormycosis during the first 2 months after heart-lung and heart transplantation.
Results:
In the first patient, the clinical presentation was insidious and the diagnosis was made at an advanced stage of the disease. Despite surgery and aggressive antifungal treatment, the patient died. In the second patient, the diagnosis was made promptly, but despite antifungal treatment, he presented with gastric perforation within a week.
Conclusions:
These cases illustrate that fungal invasive disease may be a cause of early gastrointestinal perforation after solid organ transplantation.
Insights
Gastrointestinal complications, including gastric perforation from mucormycosis, are serious risks after heart and lung transplantation. Early diagnosis and treatment are crucial but challenging in these invasive fungal infections.
Area of Science:
- Transplantation Medicine
- Infectious Diseases
- Gastroenterology
Background:
- Gastrointestinal complications frequently cause significant morbidity and mortality following heart and lung transplantation.
- Invasive fungal infections are a known, albeit less common, post-transplant complication.
Observation:
- Two cases of gastric perforation due to mucormycosis within two months of heart-lung and heart transplantation are presented.
- The first patient had an insidious presentation, diagnosed late, and succumbed despite aggressive treatment.
- The second patient experienced prompt diagnosis but still developed gastric perforation despite antifungal therapy.
Findings:
- Mucormycosis can lead to early gastric perforation in solid organ transplant recipients.
- Outcomes were poor in both cases, highlighting the aggressive nature of the infection.
- Diagnosis and treatment challenges exist even with prompt intervention.
Implications:
- Highlights the importance of considering invasive fungal infections in the differential diagnosis of early GI complications post-transplant.
- Suggests a need for heightened vigilance and potentially novel diagnostic or therapeutic strategies for mucormycosis in transplant patients.
- Underscores the critical nature of gastrointestinal complications in solid organ transplantation.