The Double-Edged Sword of Immunosuppressive Therapy in Kidney Transplantation: A Rare Case Report of Pulmonary Mucormycosis Post-Transplant and Literature Review

Frontiers in Medicine

article

Hengcheng Zhang¹  Ke Wang¹  Hao Chen¹  Li Sun¹  Zijie Wang¹  Shuang Fei¹  Ruoyun Tan¹  Min Gu¹ 

[1] Department of Urology, The First Affiliated Hospital of Nanjing Medical University;Transplantation Research Center, Brigham & Women's Hospital and Harvard Medical School, United States

关键词: case report;    pulmonary;    infection;    mucor;    immunosuppressant;    mucormycosis;    kidney transplantation;   

DOI  :  10.3389/fmed.2020.00500

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Immunosuppressive therapy is improving the graft survival of kidney transplant recipients and increasing the potential risk of infection. Pulmonary mucormycosis is a rare post-operative infection complication characterized with rapid deterioration and high mortality. In this case, a 33-year-old patient underwent a kidney transplantation with regular immunosuppressive therapy. Soon, 38 days post-transplant, pulmonary patchy shadows can be seen in the radiological examination and rounded into a large cavity formation with splenic rupture 25 days later. The diagnosis of mucormycosis was confirmed by lung biopsy and spleen histopathology. This case is a reminder that early diagnosis is imperative, meanwhile, rational antifungal therapy, timely elimination of immunosuppressants, and alternatively, abandoning the graft should be prudently assessed in the treatment of mucormycosis.

【 授权许可】

CC BY