Donor‐derived renal allograft mucormycosis in a combined liver and kidney transplantation: Case report and review of the literature

Abstract

Mucormycosis is a spectrum of angio-invasive mold infections from fungi under the order Mucorales, including but not limited to Mucor, Rhizopus, Rhizomucor, Cunninghamella, Absidia, Apophysomyces. 1 The consequences of infection are life-threatening. In addition to maintaining a high index of suspicion, the cornerstones of therapy include prompt diagnosis, reversal of underlying immune dysfunction, early antifungal therapy, and surgical debridement. 2 Mucormycosis may present in any form, but most common syndromes include rhino-orbital-cerebral, pulmonary, or cutaneous involvement, as well as disseminated infection. Isolated renal mucormycosis is rare and appears related to injection-drug use in addition to typical predisposing factors: immunocompromising conditions,

Donor-derived infections in solid organ transplant recipients

“…Donor-derived graft mucormycosis mostly derive from cases developing outside of the Western world or associated with transplant tourism. In other cases, transmission is expected to derive from contamination during procurement, organ handling, or nonsterile condition [ 49 ]. Therefore, clinicians should maintain clinical suspicion for invasive mold infections and consider antifungal prophylaxis with drugs active against molds in SOT recipients receiving organs from donors with specific risk factors [ 47 ▪▪ ].…”

Epidemiology, Modern Diagnostics, and the Management of Mucorales Infections

“…Clusters have been described in several hospital settings, including in intensive care units (ICUs) [ 117 ], transplantation units as graft-transmitted mucormycosis in liver- and kidney-transplant recipients [ 118 , 119 , 120 ], and notably in burn units [ 34 , 121 , 122 ]. Burn patients have extensive disruptions of the physical skin barrier, along with immune dysfunction.…”