• Rev Mal Respir · Nov 2009

    Case Reports

    [Non-fatal disseminated mucormycosis in a solid organ transplant].

    • C Minet, A Bonadona, A Tabah, A Karkas, L Mescam, C Schwebel, R Hamidfar, C Pison, C Saint-Raymond, O Faure, D Salameire, and J-F Timsit.
    • Unité de Pneumologie, Pôle de médecine aiguë communautaire, CHU de Grenoble, France. cminet@chu-grenoble.fr
    • Rev Mal Respir. 2009 Nov 1; 26 (9): 998-1002.

    BackgroundMucormycosis is a rare fungal infection occurring most frequently in immunocompromised patients. The pathogens are filamentous fungi, order of Mucorales. Disseminated mucormycosis is a severe, life treating disease. Early diagnosis is a major determinant for prognosis, however, it remains difficult. The management consists in an early antifungal therapy using lipid formulation of amphotericin B associated with an extensive surgical debridement. Despite this therapeutic of choice, the mortality of disseminated mucormycosis remains high.ObservationWe report the case of disseminated mucormycosis in a 25 years old woman 9 months after a pulmonary transplantation. The clinical presentation included pulmonary and thyroid localization and the pathogen was Absidia corymbifera. The patient survived thanks to a large surgical debridement, and an early antifungal bitherapy by lipid formulation of amphotericin B and posaconazole.ConclusionThe re-emergence and the high mortality of mucormycosis in solid organ transplant receiver show the necessity to find new therapeutic approaches. Posaconazole associated with liposomal amphotericin B could be an interesting option to treat disseminated mucormycosis and improve their outcome.

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