Disseminated mucormycosis masquerading as rejection early after orthotopic heart transplantation

Abstract

Mucorales organisms are an uncommon cause of invasive fungal infections after solid organ transplantation but are associated with great morbidity and mortality. We report a fatal case of disseminated Cunninghamella infection early after heart transplantation. The patient developed graft dysfunction and elevated markers of myocyte injury and autopsy revealed fulminant fungal myocarditis. This case highlights the need for a high index of suspicion in immunocompromised patients who are not improving with standard antimicrobial therapy.

Clinically latent and autopsy-verified inflammatory disorders and malignant tumours in transplant patients

“…This can be explained as secondary heart insufficiency due to sepsis. Fungal infections in particular, even in septic stage, can be a difficult differential diagnosis and, consequently, easily missed 17 43–45. In principle, an antifungal therapy could have affected survival but the prognosis remains poor nonetheless 43.…”