scholarly journals Successful Treatment of Recurrent Pulmonary Mucormycosis in a Renal Transplant Patient: A Case Report and Literature Review

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Morgan S. Martin ◽  
Alison A. Smith ◽  
Monica Lobo ◽  
Anil S. Paramesh
Keyword(s):  
Case Report ◽  
Renal Transplant ◽  
Surgical Site Infection ◽  
Opportunistic Infections ◽  
Recurrent Disease ◽  
Organ Transplant ◽  
Treatment Strategies ◽  
Solid Organ ◽  
Site Infection ◽  
Pulmonary Mucormycosis

Background. We describe the unusual case of a recently transplanted cadaveric renal transplant recipient who presented with recurrent pulmonary mucormycosis. Case Report. An 18-year-old man with end stage renal disease secondary to congenital renal agenesis status after cadaveric kidney transplant 4 months before presented with acute onset of fever, hemoptysis, and back pain. The patient underwent an emergent left lower lobectomy due to the critical nature of his illness. He was also treated with amphotericin with resolution of his symptoms. One week later, he had evidence of recurrent disease on imaging with a surgical site infection. He underwent reexploration with evacuation of an empyema and debridement of a surgical site infection. He was continued on IV antifungal therapy with isavuconazonium and amphotericin. Radiographic clearance of disease with three months of treatment was apparent with no evidence of recurrence at seven-month follow-up. Discussion. Opportunistic infections in solid organ transplant patients represent a significant source of morbidity and mortality. Most patients are treated with prophylactic anti-infective agents. However, rare infections such as pulmonary mucormycosis remain a risk. The transplant physician must be aware of these uncommon infections and their treatment strategies, including the management of uncommon recurrent disease.

Indirect Effects of Cytomegalovirus Infection

2009 ◽  
Vol 03 (01) ◽  
pp. 41 ◽  
Author(s):  
Götz Ulrich Grigoleit ◽  
Markus Kapp ◽  
Hermann Einsele ◽  
◽  
◽  
...  
Keyword(s):  
Indirect Effects ◽  
Opportunistic Infections ◽  
Organ Transplant ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Haematopoietic Stem Cell ◽  
Solid Organ ◽  
Direct Effects ◽  
Cmv Infection ◽  
Increased Risk

Primary cytomegalovirus (CMV) infection often presents as an asymptomatic self-limiting disease in immunocompetent individuals and is followed by latent persistence in different host tissues. However, solid organ transplant (SOT) recipients and patients undergoing allogeneic haematopoietic stem cell transplantation (alloHSCT) are at risk of life-threatening complications caused by CMV infection. Direct effects (or CMV disease) are marked by viral proliferation in a variety of tissues and organs. Clinical manifestations that are observed after SOT and alloHSCT are gastroenteritis, pneumonitis, hepatitis, uveitis, retinitis, encephalitis and graft rejection. In contrast to the direct effects, indirect effects are a consequence of the maintenance of persistent low-level viral replication and have been associated with an increased risk of rejection and graft dysfunction, graft-versus-host disease, accelerated atherosclerosis, opportunistic infections, malignancies, posttransplant diabetes and Guillain-Barré syndrome. This article aims to summarise these indirect effects of CMV, their possible causes and possible treatment strategies.

scholarly journals Deceptively asymptomatic cryptococcaemia in a renal transplant recipient: the lull before a storm

2019 ◽  
Vol 12 (4) ◽  
pp. e228115 ◽  
Author(s):  
Vivek Sood ◽  
Navin Pattanashetti ◽  
Raja Ramachandran ◽  
Krishan Lal Gupta
Keyword(s):  
Renal Transplant ◽  
Ischaemic Stroke ◽  
Opportunistic Infections ◽  
Organ Transplant ◽  
Induction Phase ◽  
Solid Organ ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Intracranial Vessel ◽  
Solid Organ Transplant Recipients

Cryptococcal infection constitutes around 3% of opportunistic infections in solid organ transplant recipients. Most common organ affected in renal transplant recipients (RTRs) is central nervous system and usually presents with chronic meningoencephalitis (CME). Ischaemic stroke as a consequence of cryptococcal meningoencephalitisis rare and possibly due to the involvement of intracranial vessel by exudates causing vasculitis-related thrombosis. In this context, we describe an unusual case of asymptomatic cryptococcaemia in an RTR, progressing on to acute ischaemic stroke secondary to acute CME with near complete neurological recovery following timely diagnosis, early and appropriate antifungal treatment. The index case attempts to re-emphasise the significance of mandatory screening required to exclude the possibility of dissemination of cryptococcaemia in RTRs besides highlighting the requirement of prolonged induction phase with combination therapy, particularly in presence of stroke.

scholarly journals COVID-19-associated rhino-orbital mucormycosis (CAROM)—a case report

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Humsheer Singh Sethi ◽  
Kamal Kumar Sen ◽  
Sudhansu Sekhar Mohanty ◽  
Sangram Panda ◽  
Kolluru Radha Krishna ◽  
...  
Keyword(s):  
Case Report ◽  
Health Care Professionals ◽  
Opportunistic Infections ◽  
Fungal Spores ◽  
Nasal Discharge ◽  
Contributing Factors ◽  
Post Discharge ◽  
Pulmonary Mucormycosis ◽  
The Right

Abstract Background There has been a rapid rise in the number of COVID-19-associated rhino-orbital mucormycosis (CAROM) cases especially in South Asian countries, to an extent that it has been considered an epidemic among the COVID-19 patients in India. As of May 13, 2021, 101 CAROM cases have been reported, of which 82 cases were from India and 19 from the rest of the world. On the other hand, pulmonary mucormycosis associated with COVID-19 has a much lesser reported incidence of only 7% of the total COVID-19-associated mucormycosis cases (Singh AK, Singh R, Joshi SR, Misra A, Diab Metab Syndr: Clin Res Rev, 2021). This case report attempts to familiarize the health care professionals and radiologists with the imaging findings that should alarm for follow-up and treatment in the lines of CAROM. Case presentation Rhino-orbital mucormycosis (ROM) is a manifestation of mucormycosis that is thought to be acquired by inhalation of fungal spores into the paranasal sinuses. Here, we describe a 55-year-old male, post COVID-19 status with long standing diabetes who received steroids and ventilator therapy for the management of the viral infection. Post discharge from the COVID-19 isolation ICU, the patient complained of grayish discharge from the right nostril and was readmitted to the hospital for the nasal discharge. After thorough radiological and pathological investigation, the patient was diagnosed with CAROM and managed. Conclusion Uncontrolled diabetes and imprudent use of steroids are both contributing factors in the increased number of CAROM cases. Our report emphasizes on the radiological aspect of CAROM and reinforces the importance of follow-up imaging in post COVID-19 infection cases with a strong suspicion of opportunistic infections.

Fecal Microbiota Transplantation Donor Screening Updates and Research Gaps for Solid Organ Transplant Recipients

2021 ◽  
Author(s):  
Nirja Mehta ◽  
Tiffany Wang ◽  
Rachel J. Friedman-Moraco ◽  
Cynthia Carpentieri ◽  
Aneesh K. Mehta ◽  
...  
Keyword(s):  
Opportunistic Infections ◽  
Fecal Microbiota Transplantation ◽  
Organ Transplant ◽  
Fecal Microbiota ◽  
Solid Organ Transplant ◽  
Pathogen Transmission ◽  
Solid Organ ◽  
Fecal Microbiota Transplant ◽  
Donor Screening ◽  
Clostridioides Difficile

In this review, we discuss stool donor screening considerations to mitigate potential risks of pathogen transmission through fecal microbiota transplant (FMT) in solid organ transplant (SOT) recipients. SOT recipients have a higher risk for Clostridioides difficile infection (CDI) and are more likely to have severe CDI. FMT has been shown to be a valuable tool in the treatment of recurrent CDI (RCDI), however guidelines for screening for opportunistic infections transmitted through FMT are underdeveloped. We review reported adverse effects of FMT as they pertain to an immunocompromised population and discuss current understanding and recommendations for screening found in the literature while noting gaps in research. We conclude that while FMT is being performed in the SOT population, typically with positive results, there remain many unanswered questions which may have major safety implications and warrant further study.

The Immunocompromised Surgical Patient and Opportunistic Infections

2017 ◽  
Author(s):  
Kiran Gajurel ◽  
Aruna K Subramanian
Keyword(s):  
De Novo ◽  
Opportunistic Infections ◽  
Organ Transplant ◽  
Surgical Excision ◽  
Suppressive Therapy ◽  
Surgical Patient ◽  
Solid Organ ◽  
Fungal Sinusitis ◽  
Delay In Diagnosis ◽  
Immunosuppressive Medications

Immunosuppressive medications used to prevent allograft rejection render solid-organ transplant recipients vulnerable to various opportunistic infections. These infections include bacteria, viruses, fungi, and parasites and occur either via reactivation of previously acquired latent infection or de novo acquisition from the donor organ itself or the environment after the transplantation. The type and clinical course of the infection depend on various factors, including the transplanted organ, nature of immunosuppressive regimens, timing of infection relative to the organ transplant, and type and duration of prophylaxis. Proper donor and recipient screening for preventable infections and posttransplantation prophylaxis are instrumental in preventing morbid infections. Posttransplantation infections may present with subtle findings and thus may cause a delay in diagnosis and treatment, resulting in a poor outcome. Appropriate pathogen-specific tests should be requested promptly for early diagnosis. Since these infections may have overlapping clinical and radiologic features, tissue biopsy, if feasible, should be done to establish a definitive diagnosis. Surgical excision or débridement should be attempted in patients presenting with abscesses or invasive fungal sinusitis along with antimicrobial therapy. After the completion of treatment, suppressive therapy may be required in certain infections to prevent a relapse as long as the patient remains immunosuppressed. This review contains 3 tables, and 82 references. Key words: allograft, donor, immunocompromised, infection, opportunistic, organ, transplant 

Cytomegalovirus after Kidney Transplantation: A Case Review

2005 ◽  
Vol 15 (2) ◽  
pp. 157-160
Author(s):  
Carol A. Lawson
Keyword(s):  
Kidney Transplantation ◽  
Organ Transplant ◽  
Treatment Strategies ◽  
Disease Process ◽  
Lymphoproliferative Disease ◽  
Diagnostic Methods ◽  
Solid Organ ◽  
Case Review ◽  
Posttransplant Lymphoproliferative Disease ◽  
Living Related

Cytomegalovirus is the most common infectious complication in solid-organ transplant recipients. Despite the frequency of the problem, no commonly accepted approach to cytomegalovirus prophylaxis and treatment exists. Because cytomegalovirus may lead to the modulation of the immune system sometimes causing opportunistic superinfections, allograft injury, acute rejection, chronic rejection, and development of posttransplant lymphoproliferative disease, transplant coordinators require knowledge of the disease, diagnostic methods, and treatment and prophylaxis strategies. This case study reviews a high-risk cytomegalovirus transplant recipient after living-related kidney transplantation. In addition to a review of the pathophysiology of the disease process, patient, family, and nursing staff education, and cultural and psychosocial aspects of cytomegalovirus, prophylaxis, diagnosis, treatment strategies as well as role of the transplant coordinator, will be discussed.

Delayed surgical site infection 2 years after cervical disk arthroplasty. Case report and literature review

Neurocirugía ◽  
2019 ◽  
Vol 30 (2) ◽  
pp. 81-86
Author(s):  
Aleix Rosselló ◽  
Jose Luis Sanmillán ◽  
Luis López-Obarrio ◽  
Iván Pelegrín ◽  
Andreu Gabarrós ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Surgical Site Infection ◽  
Site Infection ◽  
Cervical Disk
Sign in / Sign up

Export Citation Format

Share Document