Zygomycosis in solid organ transplant recipients in a tertiary transplant center and review of the literature

N. G. Almyroudis, D. A. Sutton, P. Linden, M. G. Rinaldi, J. Fung, S. Kusne

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155 Scopus citations

Abstract

Zygomycetes are ubiquitous fungi that can cause invasive disease associated with high mortality. We report 10 solid organ transplant recipients with zygomycosis (incidence 2 per 1000) and reviewed 106 cases in the English-language literature. These included renal (n = 73), heart (n = 16), lung (n = 4), heart/lung (n = 2), liver (n = 19) and kidney/pancreas (n = 2) transplant recipients. All patients were receiving immunosuppression and the vast majority steroids. The clinical presentation included rhino-sino-orbital (n = 20), rhinocerebral (n = 16), pulmonary (n = 28), gastrointestinal (n = 13), cutaneous (n = 18), renal (n = 6) and disseminated disease (n = 15). Most frequently isolated genera were Rhizopus (73%) followed by Mucor (13%). The overall mortality was 49%. While rhino-sino-orbital disease had the best prognosis, rhinocerebral disease had high mortality (93%) comparable to disseminated disease. A favorable outcome was associated with limited, surgically accessible disease and early surgical intervention along with amphotericin B administration.

Original languageEnglish (US)
Pages (from-to)2365-2374
Number of pages10
JournalAmerican Journal of Transplantation
Volume6
Issue number10
DOIs
StatePublished - Oct 1 2006

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Keywords

  • Mould
  • Mucorales
  • Solid organ transplantation
  • Zygomycosis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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