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The Double-Edged Sword of Immunosuppressive Therapy in Kidney Transplantation: A Rare Case Report of Pulmonary Mucormycosis Post-Transplant and Literature Review

Journal

FRONTIERS IN MEDICINE
Volume 7, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fmed.2020.00500

Keywords

case report; pulmonary; infection; mucor; immunosuppressant; mucormycosis; kidney transplantation

Funding

  1. National Natural Science Foundation of China [81900684, 81870512, 81770751, 81570676, 81470981, 81100532]
  2. Project of Jiangsu Province for Important Medical Talent [ZDRCA2016025]
  3. 333 High Level Talents Project in Jiangsu Province [BRA2017532, BRA2016514, BRA2015469]
  4. Standardized Diagnosis and Treatment Research Program of Key Diseases in Jiangsu Province [BE2016791]
  5. Open Project Program of Health Department of Jiangsu Province [JSY-2-2016-099]
  6. Jiangsu Province Natural Science Foundation Program [BK20191063]

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Immunosuppressive therapy is improving the graft survival of kidney transplant recipients and increasing the potential risk of infection. Pulmonary mucormycosis is a rare post-operative infection complication characterized with rapid deterioration and high mortality. In this case, a 33-year-old patient underwent a kidney transplantation with regular immunosuppressive therapy. Soon, 38 days post-transplant, pulmonary patchy shadows can be seen in the radiological examination and rounded into a large cavity formation with splenic rupture 25 days later. The diagnosis of mucormycosis was confirmed by lung biopsy and spleen histopathology. This case is a reminder that early diagnosis is imperative, meanwhile, rational antifungal therapy, timely elimination of immunosuppressants, and alternatively, abandoning the graft should be prudently assessed in the treatment of mucormycosis.

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