Mucormycosis is a rare and often fatal opportunistic fungal infection following organ transplantation. We report our experience of clinical findings, diagnostic procedures, treatment and outcome of Mucormycosis diagnosed in renal transplant recipients admitted to 6 transplant centers. From 2000 to 2008 we observed 15 cases of Mucormycosis, 10 male and 5 female. Their mean age was 48±11 (ranged from 25 to 67) years and the median time of diagnosis since transplantation was 15 (1-72) months. Diagnosis was made by radiological findings, positive cultures (blood, nasal swabs and bronchoalveolar lavage) and tissue biopsies. Rhino-cerebral mucormycosis was the most common form of the disease (n=8, 53.3%) and followed by lung involvement (n=4, 26.6%), skin lesion (n=2, 13.3%) and disseminated infection (n=1, 6.6%). Immunosuppressive regimen in all patients was cyclosporine based; 9 and 4 recipients received mycophenolate mofetil and azathioprine, respectively. Patients with mucormycosis did not experience more graft loss. Immunosuppression and diabetes (n=6) were major factors predisposing to mucormycosis in renal transplant patients. Aggressive surgical debridement was employed in 10 cases and amphotericin B was administrated in all patients, death occurred in 8 (53.3%) patients. Mucormycosis is a devastating, rapidly progressive and often fatal infection following kidney transplantation, although patients with limited rhino-cerebral disease may have a better prognosis, especially with early diagnosis and aggressive surgical debridement and antifungal therapy.
Volume : 6
Issue : 4
Pages : 179
Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran