First reported case of late recurrence of pulmonary mucormycosis in a renal transplant recipient with poorly controlled diabetes mellitus.
Cheuk Cheung Derek LeungYu Hong ChanMan Ying HoMing Chiu ChanChun Hoi ChenChin Tong KwokYiu Cheong YeungPublished in: Respirology case reports (2021)
Pulmonary mucormycosis (PM) is a rare, life-threatening fungal infection usually affecting immunocompromised patients. Its incidence is rising, with a recent outbreak associated with COVID-19 co-infection. Amphotericin B along with early surgery are considered the standard treatment. Recurrence has been reported in patients without adequate treatment and without permanent reversal of predisposing factors. We report a case of late recurrence of PM in a renal transplant recipient. In 2012, he was diagnosed with PM. Imaging at the time showed a lingular mass. He was treated with antifungal for 1 year until complete radiological resolution. Surgical intervention was considered but no further follow-up action was taken. In 2020, he presented with fever and haemoptysis. Imaging again showed a lingular mass, which was confirmed to be PM by bronchoscopic lung biopsy. This case highlights the importance of secondary antifungal prophylaxis for PM if permanent reversal of immunosuppression is not possible.
Keyphrases
- particulate matter
- air pollution
- end stage renal disease
- newly diagnosed
- heavy metals
- ejection fraction
- chronic kidney disease
- polycyclic aromatic hydrocarbons
- coronavirus disease
- prognostic factors
- pulmonary hypertension
- sars cov
- randomized controlled trial
- type diabetes
- candida albicans
- metabolic syndrome
- patient reported outcomes
- intensive care unit
- acute coronary syndrome
- patient reported
- risk assessment
- atrial fibrillation
- percutaneous coronary intervention
- mass spectrometry
- single molecule
- smoking cessation
- replacement therapy