Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy

Overview

Journal Case Rep Transplant

Publisher Wiley

Specialty General Surgery

Date 2019 Apr 23

PMID 31007963

Citations 8

Authors

Imran Gani

Atbin Doroodchi

Kristina Falkenstrom

Holly Berry

Won Lee

Laura Mulloy

Muhammad Saeed

Rajan Kapoor

Affiliations

Soon will be listed here.

Abstract

Gastrointestinal mucormycosis is a rare infection in solid organ transplant recipients. Our patient, a 79-year-old male, presented with severe dysphagia and odynophagia about 2 weeks after receiving a renal transplant. An upper gastrointestinal (UGI) endoscopy revealed esophagitis and gastric ulceration, the cultures from which grew Rhizopus species. A usual treatment strategy should include Amphotericin B as monotherapy or in combination with Posaconazole or Isavuconazole for such infections. Our patient was treated with Isavuconazole monotherapy, in an effort to minimize renal toxicity from Amphotericin B to the new allograft. Unique to our case was a successful clinical response and resolution of UGI lesions with Isavuconazole monotherapy. Due to the vagueness of presenting symptoms, such infections can be easily missed in an immunocompromised patient which can have tragic outcomes. Prompt diagnosis and modulation of immunosuppression are essential to decrease mortality and morbidity. Isavuconazole is a novel agent and can be used as a monotherapy for such infections, especially in renal transplant recipients.

Citing Articles

Use of isavuconazole in mucormycosis: a systematic review.

Gunathilaka S, Keragala R, Gunathilaka K, Wickramage S, Bandara S, Senevirathne I BMC Infect Dis. 2025; 25(1):25.

PMID: 39762765 PMC: 11702088. DOI: 10.1186/s12879-025-10439-y.

Epidemiology, Clinical Manifestations, and Outcome of Mucormycosis in Solid Organ Transplant Recipients: A Systematic Review of Reported Cases.

Palomba E, Colaneri M, Azzara C, Fava M, Maccaro A, Renisi G Open Forum Infect Dis. 2024; 11(6):ofae043.

PMID: 38887489 PMC: 11181195. DOI: 10.1093/ofid/ofae043.

Isavuconazole for Treating Invasive Mould Disease in Solid Organ Transplant Recipients.

Tiago Silva J, Husain S, Aguado J Transpl Int. 2024; 36:11845.

PMID: 38161768 PMC: 10754982. DOI: 10.3389/ti.2023.11845.

A successfully treated gastric mucormycosis in an immunocompetent patient: Case report and literature review.

Albtoosh A, Shafei M, Al Hayek S, Ramdan L, Shahin N, Alzyoud M Clin Case Rep. 2023; 11(6):e7540.

PMID: 37334344 PMC: 10276240. DOI: 10.1002/ccr3.7540.

Characterizing patients with rare mucormycosis infections using real-world data.

Zhang Y, Sung A, Rubinstein E, Benigno M, Chambers R, Patino N BMC Infect Dis. 2022; 22(1):154.

PMID: 35164701 PMC: 8845356. DOI: 10.1186/s12879-022-07115-w.

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