First reported case of late recurrence of pulmonary mucormycosis in a renal transplant recipient with poorly controlled diabetes mellitus

Cheuk Cheung Derek Leung; Yu Hong Chan; Man Ying Ho; Ming Chiu Chan; Chun Hoi Chen; Chin Tong Kwok; Yiu Cheong Yeung

doi:10.1002/rcr2.877

First reported case of late recurrence of pulmonary mucormycosis in a renal transplant recipient with poorly controlled diabetes mellitus

Respirol Case Rep. 2021 Nov 10;9(12):e0877. doi: 10.1002/rcr2.877. eCollection 2021 Dec.

Authors

Cheuk Cheung Derek Leung¹, Yu Hong Chan¹, Man Ying Ho¹, Ming Chiu Chan¹, Chun Hoi Chen¹, Chin Tong Kwok¹, Yiu Cheong Yeung¹

Affiliation

¹ Department of Medicine & Geriatrics Princess Margaret Hospital Hong Kong.

Abstract

Pulmonary mucormycosis (PM) is a rare, life-threatening fungal infection usually affecting immunocompromised patients. Its incidence is rising, with a recent outbreak associated with COVID-19 co-infection. Amphotericin B along with early surgery are considered the standard treatment. Recurrence has been reported in patients without adequate treatment and without permanent reversal of predisposing factors. We report a case of late recurrence of PM in a renal transplant recipient. In 2012, he was diagnosed with PM. Imaging at the time showed a lingular mass. He was treated with antifungal for 1 year until complete radiological resolution. Surgical intervention was considered but no further follow-up action was taken. In 2020, he presented with fever and haemoptysis. Imaging again showed a lingular mass, which was confirmed to be PM by bronchoscopic lung biopsy. This case highlights the importance of secondary antifungal prophylaxis for PM if permanent reversal of immunosuppression is not possible.

Keywords: Rhizopus; diabetes mellitus; pulmonary mucormycosis; recurrence; renal transplant.

Publication types

Case Reports