Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy
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 ulcera...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2019/9839780 |
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| _version_ | 1832549519004270592 |
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| author | Imran Gani Atbin Doroodchi Kristina Falkenstrom Holly Berry Won Lee Laura Mulloy Muhammad Saeed Rajan Kapoor |
| author_facet | Imran Gani Atbin Doroodchi Kristina Falkenstrom Holly Berry Won Lee Laura Mulloy Muhammad Saeed Rajan Kapoor |
| author_sort | Imran Gani |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-6a2be01e57bb465c851fce4a056a5a35 |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-6a2be01e57bb465c851fce4a056a5a352025-02-03T06:11:03ZengWileyCase Reports in Transplantation2090-69432090-69512019-01-01201910.1155/2019/98397809839780Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole MonotherapyImran Gani0Atbin Doroodchi1Kristina Falkenstrom2Holly Berry3Won Lee4Laura Mulloy5Muhammad Saeed6Rajan Kapoor7Department of Nephrology, Hypertension and Transplant Medicine, Augusta University Health, Augusta, GA, USADivision of Transplant Surgery, Department of Surgery, Augusta University Health, Augusta, GA, USADivision of Transplant Surgery, Department of Surgery, Augusta University Health, Augusta, GA, USADepartment of Pharmacy, Augusta University Health, Augusta, GA, USADepartment of Pathology, Augusta University Health, Augusta, GA, USADepartment of Nephrology, Hypertension and Transplant Medicine, Augusta University Health, Augusta, GA, USADivision of Transplant Surgery, Department of Surgery, Augusta University Health, Augusta, GA, USADepartment of Nephrology, Hypertension and Transplant Medicine, Augusta University Health, Augusta, GA, USAGastrointestinal 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.http://dx.doi.org/10.1155/2019/9839780 |
| spellingShingle | Imran Gani Atbin Doroodchi Kristina Falkenstrom Holly Berry Won Lee Laura Mulloy Muhammad Saeed Rajan Kapoor Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy Case Reports in Transplantation |
| title | Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy |
| title_full | Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy |
| title_fullStr | Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy |
| title_full_unstemmed | Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy |
| title_short | Gastric Mucormycosis in a Renal Transplant Patient Treated with Isavuconazole Monotherapy |
| title_sort | gastric mucormycosis in a renal transplant patient treated with isavuconazole monotherapy |
| url | http://dx.doi.org/10.1155/2019/9839780 |
| work_keys_str_mv | AT imrangani gastricmucormycosisinarenaltransplantpatienttreatedwithisavuconazolemonotherapy AT atbindoroodchi gastricmucormycosisinarenaltransplantpatienttreatedwithisavuconazolemonotherapy AT kristinafalkenstrom gastricmucormycosisinarenaltransplantpatienttreatedwithisavuconazolemonotherapy AT hollyberry gastricmucormycosisinarenaltransplantpatienttreatedwithisavuconazolemonotherapy AT wonlee gastricmucormycosisinarenaltransplantpatienttreatedwithisavuconazolemonotherapy AT lauramulloy gastricmucormycosisinarenaltransplantpatienttreatedwithisavuconazolemonotherapy AT muhammadsaeed gastricmucormycosisinarenaltransplantpatienttreatedwithisavuconazolemonotherapy AT rajankapoor gastricmucormycosisinarenaltransplantpatienttreatedwithisavuconazolemonotherapy |