Successful treatment of mucormycosis after kidney transplantation.
Fungal infections are rare but represent serious complications following organ transplantation. We present a case of mucormycosis primarily affecting the paranasal sinuses in a 51-year-old man with a kidney allograft. The patient presented with headache, left facial and orbital pain, nasal discharge, and elevation of serum creatinine 18 months after kidney transplantation. Laboratory tests revealed cyclosporine nephrotoxicity, cytomegalovirus infection, and prediabetes. Imaging findings were compatible with left maxillary, ethmoidal, and sphenoidal sinusitis. Diagnosis was made based on pathologic findings and detection of typical fungal hyphea in the infected tissues. The patient was successfully treated by discontinuation of cyclosporine and mycophenolate mofetil, initiation of systemic amphotericin B, and aggressive surgical debridement.
Division of Nephrology, Department of Internal Medicine, Shohada-e-Tajrish Hospital, Shahid Beheshti University (MC), Tehran, Iran. amiladi@hotmail.com
Amirhossein
A
Miladipour
Esmat
E
Ghanei
Alireza
A
Nasrollahi
Habibollah
H
Moghaddasi
D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D016572:Cyclosporine / Q000009:adverse effects; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000188:drug therapy* / Q000276:immunology; D012852:Sinusitis / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D014081:Tooth Extraction / Q000009:adverse effects
D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D000666:Amphotericin B; D016572:Cyclosporine