Successful Treatment of Pulmonary Mucormycosis in a Renal Transplant Recipient with Limited Pulmonary Reserve by Combined Medical and Surgical Therapy

Li, Jordan Y.Z.; Yong, Tuck Y.; Jurisevic, Craig A.; Russ, Graeme R.; Grove, David I.; Coates, P. Toby H.; Disney, Alex P.S.

doi:10.1016/j.hlc.2007.12.003

« Previous Next »Heart, Lung and Circulation
Volume 18, Issue 3 , Pages 226-228, June 2009

Successful Treatment of Pulmonary Mucormycosis in a Renal Transplant Recipient with Limited Pulmonary Reserve by Combined Medical and Surgical Therapy

Jordan Y.Z. Li, FRACP
- Department of Nephrology and Transplantation Services, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Corresponding author at: Department of Medicine, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia. Tel.: +61 8 8204 6249; fax: +61 8 8204 6255.
Tuck Y. Yong, FRACP
- Department of Endocrinology, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
Craig A. Jurisevic, FRACS
- Department of Cardiothoracic Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Department of Surgery, University of Adelaide, Adelaide, South Australia, Australia
Graeme R. Russ, FRACP
- Department of Nephrology and Transplantation Services, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
David I. Grove, FRACP
- Department of Clinical Microbiology and Infectious Diseases, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
P. Toby H. Coates, FRACP
- Department of Nephrology and Transplantation Services, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
Alex P.S. Disney, FRACP
- Department of Nephrology and Transplantation Services, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia

Received 15 October 2007; accepted 22 December 2007.

Mucormycosis is a rare opportunistic fungal infection in renal transplant recipients which is associated with exceedingly high mortality when inadequately treated. Risk factors for this infection include diabetes, neutropaenia and immunosuppression. We report a case of pulmonary mucormycosis in a renal allograft recipient with type 2 diabetes and limited pulmonary reserve. The patient was successfully treated with lobectomy and liposomal amphotericin B with preservation of pulmonary and allograft functions. Early recognition of this infection is warranted before dissemination, which carries a poor prognosis.

Keywords: Pulmonary mucormycosis, Kidney transplantation, Fungal infection, Immunosuppression, Diabetes