medigraphic.com
ISSN 2007-6800 (Print)

2025, Number 1

<< Back Next >>

Rev Mex Traspl 2025; 14 (1)

Rinosenoorbital mucormycosis after kidney transplant. Report of two case and review of the literature

Sánchez-Rodríguez R, Espinoza-Pérez R, Cancino-López J, Bautista-Olayo R, Guerrero-Rosario A, Rodríguez-Gómez R, Cedillo-Galindo H, Morinelli-Astorquizaga A, Hernández-Díaz JC, Hernández-Rodríguez JC, Cruz-López M, Reyes-Díaz E, Valdez-Mendieta HY

Language: Spanish
References: 25
Page: 27-33
PDF size: 412.98 Kb.


ABSTRACT

Introduction: mucormycosis is a deep or systemic fungal infection with rapid progression and high morbidity and mortality caused by opportunistic fungi. Present mainly in immunosuppressed patients such as transplant recipients, which can spread and cause high morbidity and mortality. Case presentation: we present two cases of rhinosenorbital mucormycosis, present after kidney transplantation under immunosuppression with basiliximab and thymoglobulin. Both debuted abruptly and had a progressive and invasive evolution, with clinical presentation characteristics that coincide with cases previously reported in the literature, in which multidisciplinary medical management was established with liposomal amphotericin B and surgery through intense debridement to eliminate infarcted and necrotic tissues, as part of the treatment of choice, as dictated by the guidelines in the clinical practice guidelines, which allowed us to corroborate the effectiveness of the established medical-surgical treatment, leading to a favorable outcome, with limitation of the condition. mucocutaneous and mainly, with adequate kidney graft function. Conclusions: despite the great advances in the improvement of antifungal treatment, the presentation of these patients confirms the effectiveness that treatment with Amphotericin still maintains for this entity, which allows it to remain the gold standard in the treatment of mucormycosis.


REFERENCES

  1. Einollahi B, Lessan-Pezeshki M, Aslani J, Nemati E, Rostami Z, Hosseini MJ et al. Two decades of experience in mucormycosis after kidney transplantation. Ann Transplant. 2011; 16 (3): 44-48.

  2. Chkhotua A, Yussim A, Tovar A, Weinberger M, Sobolev V, Bar-Nathan N et al. Mucormycosis of the renal allograft: case report and review of the literature. Transpl Int. 2001; 14 (6): 438-441.

  3. Navarro Vergara DI, Barragán Pola G, Bonifaz A, Núñez Pérez-Redondo C, Choreño García O, Cicero Sabido R. Mucormicosis pulmonar en un paciente con trasplante renal y hemoptisis incoercible. Rev Iberoam Micol. 2017; 34 (4): 233-236.

  4. Cocanour CS, Miller-Crotchett P, Reed RL 2nd, Johnson PC, Fischer RP. Mucormycosis in trauma patients. J Trauma. 1992; 32 (1): 12-15.

  5. Walsh TJ, Gamaletsou MN, McGinnis MR, Hayden RT, Kontoyiannis DP. Early clinical and laboratory diagnosis of invasive pulmonary, extrapulmonary, and disseminated mucormycosis (zygomycosis). Clin Infect Dis. 2012; 54 Suppl 1: S55-S60.

  6. Aslani J, Eizadi M, Kardavani B, Khoddami-Vishteh HR, Nemati E, Hoseini SM et al. Mucormycosis after kidney transplantations: report of seven cases. Scand J Infect Dis. 2007; 39 (8): 703-706.

  7. Nieto-Ríos JF, Moreno-Coral LF, Zapata-Cárdenas A, Ocampo-Kohn C, Aristizabal-Alzate A, Serna-Higuita LM et al. Tratamiento exitoso de mucormicosis rino-órbito-cerebral en un paciente trasplantado renal. Nefrología (Madr.). 2014; 34 (1): 120-124.

  8. Aldama Caballero A, García Duarte J, Aldama Negrete F, Insaurralde S, Mendoza de Sánchez G, Celías L. Mucormicosis rinocerebral - Reporte de 4 casos. An Fac Cienc Méd (Asunción). 2017; 50 (3): 75-82.

  9. Chou LS, Lewis RE, Ippoliti C, Champlin RE, Kontoyiannis DP. Caspofungin as primary antifungal prophylaxis in stem cell transplant recipients. Pharmacotherapy. 2007; 27 (12): 1644-1650.

  10. Gomes MZ, Lewis RE, Kontoyiannis DP. Mucormycosis caused by unusual mucormycetes, non-Rhizopus, -Mucor, and -Lichtheimia species. Clin Microbiol Rev. 2011; 24 (2): 411-445.

  11. Hamilos G, Samonis G, Kontoyiannis DP. Pulmonary mucormycosis. Semin Respir Crit Care Med. 2011; 32 (6): 693-702.

  12. Walsh TJ, Bloom BE, Kontoyiannis DP. Meeting the challenges of an emerging pathogen: the Henry Schueler 41&9 Foundation International Forum on Mucormycosis. Clin Infect Dis. 2012; 54 Suppl 1: S1-S4.

  13. Kubak BM, Huprikar SS; AST Infectious Diseases Community of Practice. Emerging & rare fungal infections in solid organ transplant recipients. Am J Transplant. 2009; 9 Suppl 4: S208-S226.

  14. Bonifaz A. Capítulo 28: Mucormicosis y entomoftoromicosis (zigomicosis). Micología médica básica. 4a edición. México: McGraw-Hill; 2012. pp. 399-426.

  15. Kontoyiannis DP, Lionakis MS, Lewis RE, Chamilos G, Healy M, Perego C et al. Zygomycosis in a tertiary-care cancer center in the era of Aspergillus-active antifungal therapy: a case-control observational study of 27 recent cases. J Infect Dis. 2005; 191 (8): 1350-1360.

  16. Kwon-Chung KJ. Taxonomy of fungi causing mucormycosis and entomophthoramycosis (zygomycosis) and nomenclature of the disease: molecular mycologic perspectives. Clin Infect Dis. 2012; 54 Suppl 1 (Suppl 1): S8-S15.

  17. Prasad PA, Vaughan AM, Zaoutis TE. Trends in zygomycosis in children. Mycoses. 2012; 55 (4): 352-356.

  18. Spellberg B, Ibrahim AS. Recent advances in the treatment of mucormycosis. Curr Infect Dis Rep. 2010; 12 (6): 423-429.

  19. Chamilos G, Lewis RE, Kontoyiannis DP. Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis. Clin Infect Dis. 2008; 47 (4): 503-509.

  20. Torres-Narbona M, Guinea J, Muñoz P, Bouza E. Zigomicetos y zigomicosis en la era de las nuevas terapias antifúngicas. Rev Esp Quimioter. 2007; 20 (4): 375-386.

  21. Gamaletsou M, Sipsas N, Roilides E, Walsh T. Rhino-orbital-cerebral mucormycosis. Curr Infect Dis Rep. 2012; 14 (4): 423-434.

  22. Spellberg B, Walsh TJ, Kontoyiannis DP, Edwards J Jr, Ibrahim AS. Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis. 2009; 48 (12): 1743-1751.

  23. Reed C, Bryant R, Ibrahim AS, Edwards J Jr, Filler SG, Goldberg R et al. Combination polyene-caspofungin treatment of rhino-orbital-cerebral mucormycosis. Clin Infect Dis. 2008; 47 (3): 364-371.

  24. Espinel-Ingroff A, Chakrabarti A, Chowdhary A, Cordoba S, Dannaoui E, Dufresne P et al. Multicenter evaluation of MIC distributions for epidemiologic cutoff value definition to detect amphotericin B, posaconazole, and itraconazole resistance among the most clinically relevant species of Mucorales. Antimicrob Agents Chemother. 2015; 59 (3): 1745-1750.

  25. Badiee P, Abdolvahab A. Invasive fungal infections in renal transplant recipients. Exp Clin Transplant. 2011; 9 (6): 355-362.




2020     |     www.medigraphic.com