Renal Mucormycosis: A Rare and Potentially Lethal Complication of Kidney TransplantationReport as inadecuate




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Case Reports in TransplantationVolume 2013 2013, Article ID 915423, 6 pages

Case Report

Division of Vascular Surgery, Department of Surgery, Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee, WI 53226, USA

Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA

Division of Transplantation, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA

Received 9 August 2013; Accepted 8 September 2013

Academic Editors: P. A. Andrews, G. Forrest, and M. Klinger

Copyright © 2013 SreyRam Kuy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Renal mucormycosis is a rare and potentially lethal complication of kidney transplantation. We describe two cases of renal mucormycosis following deceased donor kidney transplantation. This is the second report of renal mucormycosis following kidney transplantation in the United States, and the first case of renal mucormycosis infection presumed to be of recipient origin. Case A had an early presentation of mucormycosis isolated to the kidney allograft. He had an unexpected rise in serum creatinine and leukocytosis necessitating allograft biopsy which showed mucormycosis. He underwent transplant nephrectomy on posttransplant day 11, was treated with amphotericin B, and discharged home on posttransplant day 22. Case B had a late presentation of renal mucormycosis, preceded by a cutaneous manifestation. One year after kidney transplantation he had a nonhealing knee ulcer which on biopsy showed cutaneous mucormycosis. Treatment included aggressive debridement and amphotericin B. Allograft biopsy showed mucormycosis, necessitating transplant nephrectomy. He was discharged to a rehabilitation facility and died from noninfectious causes. Review of the published literature of renal mucormycosis cases following kidney transplantation reveals a mortality rate of more than 50%. The key to successful outcome is early recognition, prompt institution of surgical debridement of all infected tissue, and appropriate antifungal therapy.





Author: SreyRam Kuy, Chun He, and David C. Cronin II

Source: https://www.hindawi.com/



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