Disseminated mucormycosis masquerading as rejection early after orthotopic heart transplantation

Transpl Infect Dis. 2018 Feb;20(1). doi: 10.1111/tid.12820. Epub 2018 Jan 16.

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.

Keywords: fungal infections; heart transplantation; mucormycosis.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use
  • Cunninghamella / isolation & purification*
  • Fatal Outcome
  • Graft Rejection*
  • Heart Transplantation / adverse effects*
  • Humans
  • Immunocompromised Host
  • Invasive Fungal Infections / blood
  • Invasive Fungal Infections / diagnosis*
  • Invasive Fungal Infections / drug therapy
  • Invasive Fungal Infections / microbiology
  • Lung Diseases, Fungal / complications
  • Lung Diseases, Fungal / drug therapy
  • Lung Diseases, Fungal / microbiology
  • Male
  • Middle Aged
  • Mucormycosis / blood*
  • Mucormycosis / diagnosis
  • Mucormycosis / drug therapy
  • Mucormycosis / microbiology
  • Muscle Cells
  • Myocarditis / microbiology
  • Opportunistic Infections / blood
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / microbiology

Substances

  • Antifungal Agents