Case of early-disseminated Rhizopus microsporus var. microsporus mucormycosis in a renal transplant patient

Abstract

Mucormycosis is a rare infection caused by the ubiquitous filamentous fungi of the order Mucorales and class Zygomycetes. These species are vasotropic, causing rapid onset of tissue infarctions and necrosis and subsequent thrombosis by invading vascular bed. The disease spectrum ranges from involvement of skin, sinuses, lung, and brain to disseminated and mostly fatal infections, especially in immunocompromised hosts. Here, we present a case of a fatal disseminated mucormycosis in a 56-year-old female who had deceased donor renal allograft transplantation ~2 weeks prior to presentation. She presented with shortness of breath and dry cough. Despite being on broad-spectrum antibiotics/antifungals and proper management by transplant, infectious disease, and primary team, she died within 3 weeks of admission. Autopsy showed disseminated mucormycosis of lungs and thyroid. Disseminated infection within 2 weeks of solid organ transplantation in this patient was one of the rare features of mucormycosis.

Epidemiology and Treatment Outcome of Mucormycosis in Khuzestan, Southwest of Iran

“…Mucormycosis is an uncommon life-threatening infection caused by fungi of class Zygomycetes, other Mucorales, and are ubiquitous fungi in the environment that are commonly found in decaying organic substrates, including bread, fruits, vegetables, soil, compost piles and animal excreta (1)(2)(3)(4). The principle risk factors associated with mucormycosis include uncontrolled diabetes and diabetic ketoacidosis, prolonged steroid therapy, persistent neutropenia, deferoxamine therapy, hematological malignancies, illicit use of intravenous drugs, autoimmune disorders, prophylaxis with voriconazole or echinocandins, and cutaneous or mucous membrane barrier due to trauma, burns and surgical wounds.…”

Rhizopus microsporus pulmonary sepsis: Case report and review of literature

“…To date, only 17 cases of R. microsporus involving lungs as site of infection (pulmonary mucormycosis) has been reported in the literature and are listed in Table I. [3][4][5]11,[15][16][17][18][19][20] The patients included 12 males and 5 females with the average age of 62 (28-88) years. 5 cases were reported from India, 4 from Belgium, 2 from United States and one case each from United Kingdom, Kenya, Japan, Czechia, The Netherlands and South Korea.…”