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. 2012 Jun;54(11):1629-36.
doi: 10.1093/cid/cis195. Epub 2012 Mar 19.

Mucormycosis in organ and stem cell transplant recipients

Fanny Lanternier  1 , Hsin-Yun Sun, Patricia Ribaud, Nina Singh, Dimitrios P Kontoyiannis, Olivier Lortholary
Affiliations

Mucormycosis in organ and stem cell transplant recipients

Fanny Lanternier et al. Clin Infect Dis. 2012 Jun.

Abstract

Mucormycosis is a devastating invasive fungal disease whose incidence has increased during the past decade. Mucormycosis now represents a major threat in transplant recipients, accounting for 2% and 8% of invasive fungal infections in recent cohorts of solid-organ and allogeneic stem-cell transplant recipients, respectively. Mucormycosis most often occurs late, >3 months after transplantation, although cases occurring early have been observed, especially among liver transplant recipients and in cases of graft-transmitted infection. Recent guidelines have emphasized the direct examination of the involved fluid or tissue and culture from a sterile site as the most appropriate diagnostic strategy and the use of lipid formulations of amphotericin B and major surgery when feasible as the most appropriate first-line therapeutic strategy for mucormycosis in organ and stem cell transplant recipients.

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Conflict of interest statement

All authors: No reported conflicts.

All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Twelve-month cumulative incidence of mucormycosis among solid-organ transplant (SOT) recipients in the TRANSNET study (adapted from Park et al, Emerg Infect Dis 2011 [18], with permission from B. Park).
Figure 2.
Figure 2.
Twelve-month cumulative incidence of mucormycosis for hematopoietic stem-cell transplant (HSCT) recipients, by donor type, in the TRANSNET study. ALLOMMR, allogeneic mismatched related donor; ALLOMRD, allogeneic matched related donor; ALLOURD, allogeneic unrelated donor (adapted from Park et al, Emerg Infect Dis 2011 [18], with permission from B. Park).
Figure 3.
Figure 3.
Thirty-eight-year-old man with acute myeloid leukemia, cord blood transplanted with refractory neutropenic fever. Contrast-enhanced chest computed tomography (lung windows) at the level of the main pulmonary artery demonstrates multiple pulmonary nodules (arrows), some of which have a ground glass halo surrounding them and a right upper lobe consolidative mass (M). Biopsy demonstrated fungal hyphae consistent with mucormycosis. Numerous additional nodules were seen throughout the remainder of the lungs (not shown).
Figure 4.
Figure 4.
Distribution of Mucorales species among hematopoietic stem-cell transplant (HSCT; A) and solid-organ transplant (SOT; B) recipients in the TRANSNET study (adapted from Park et al, Emerg Infect Dis 2011 [18], with permission from B. Park).
See this image and copyright information in PMC

References

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