Successful treatment and limb salvage of mucor necrotizing fasciitis after kidney transplantation with posaconazole.
This is a case of mucormycosis complicated by necrotizing fasciitis in a renal transplant recipient on immunosuppressive therapy treated with posaconazole. Mucormycosis occurs most commonly as an opportunistic infection in the immunocompromised host. This patient, with predisposing risk factors for infection, including diabetes mellitus status post cadaveric renal transplantation on immunosuppressive therapy, is the first reported case of successful treatment of Mucor involving an extremity which was neither fatal nor required extremity amputation.
Harada
Abigail S
AS
Department of Medicine, University of Hawai'i, John A. Burns School of Medicine, Honolulu, HI 96813, USA. haradaa@niaid.nih.gov
Lau
William
W
D000421:Alcaligenes; D000666:Amphotericin B / Q000494:pharmacology / Q000627:therapeutic use; D000671:Amputation, Surgical; D000935:Antifungal Agents / Q000627:therapeutic use*; D002437:Cefazolin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000276:immunology; D003928:Diabetic Nephropathies / Q000601:surgery; D004338:Drug Combinations; D026141:Drug Resistance, Multiple, Fungal; D004927:Escherichia coli Infections / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D017809:Fatal Outcome; D015725:Fluconazole / Q000494:pharmacology / Q000627:therapeutic use; D005734:Gangrene / Q000601:surgery; D006084:Graft Rejection; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation; D007866:Leg / Q000098:blood supply / Q000601:surgery; D007871:Leg Ulcer / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009089:Mucor / Q000187:drug effects; D009091:Mucormycosis / Q000150:complications / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology / Q000601:surgery; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010713:Phosphatidylcholines / Q000494:pharmacology / Q000627:therapeutic use; D010715:Phosphatidylglycerols / Q000494:pharmacology / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology / Q000601:surgery; D011743:Pyrimidines / Q000494:pharmacology / Q000627:therapeutic use; D006435:Renal Dialysis; D012086:Reoperation; D018805:Sepsis / Q000209:etiology; D016038:Skin Transplantation; D000078142:Tazobactam; D014230:Triazoles / Q000494:pharmacology / Q000627:therapeutic use*; D065819:Voriconazole
D000935:Antifungal Agents; D004338:Drug Combinations; D007166:Immunosuppressive Agents; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; C101425:posaconazole; D000666:Amphotericin B; D010397:Penicillanic Acid; D015725:Fluconazole; D002437:Cefazolin; D065819:Voriconazole; D000078142:Tazobactam; D010878:Piperacillin