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Mucormycosis in Solid Organ Transplant

  • Fungal Infections in Transplantation (S Shoham, Section Editor)
  • Published:
Current Fungal Infection Reports Aims and scope Submit manuscript

Abstract

Purpose of review

Although mucormycosis remains an uncommon opportunistic fungal infection, new advances in diagnostic testing and in treatment have evolved to manage patients with such infections. The goal of this review is to determine how such advances have affected the management of mucormycosis.

Recent Findings

Fungal prophylaxis with voriconazole or caspofungin may increase the risk of mucormycosis in transplant recipients. Imaging the affected organ systems permits the extent of disease to be delineated and can inform decisions on surgical therapy. First-line treatment includes high-dose liposomal amphotericin B; intravenous isavuconazole and intravenous or delayed-release tablet posaconazole are alternatives and are also options for salvage therapy. Combination therapy has not proven to be more effective than monotherapy.

Summary

Optimal management of mucormycosis depends on early recognition of the disease patterns and on confirmation with culture when possible. Biomarkers of fungal for diagnosis and management are not specific enough and more research in this area might permit pre-emptive therapy when applied to high-risk recipients. Effective therapy is generally a combination of surgery with an antifungal agent.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Shoham S, Dominguez EA; On behalf of the AST Infectious Diseases Community of Practice. Emerging fungal infections in solid organ transplant recipients: guidelines of the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33:e13525. https://doi.org/10.1111/ctr.13525. A thorough review of emerging fungal infections, including mucormycosis, from most recent guidelines of the American Society of Transplantation Infectious Diseases Community of Practice.

  2. Jeong W, Keighley C, Wolfe R, Lee WL, Slavin MA, Kong DCM, Chen SC. The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports. Clin Microbiol Infect. 2019;25(1):26–34. This review and meta-analysis explores the association between the different syndromes of mucormycosis, predisposing factors, and causative species. Such knowledge might permit more targeted therapy early in the course of disease.

  3. Martin MS, Smith AA, Lobo M, Paramesh AS. Successful treatment of recurrent pulmonary mucormycosis in a renal transplant patient: a Case report and literature review. Case Rep Transplant. 2017;2017:1925070.

    PubMed  PubMed Central  Google Scholar 

  4. Skiada A, Pavleas I, Drogari-Apiranthitou M. Epidemiology and diagnosis of mucormycosis: an update. J Fungi (Basel). 2020;6(4):265. A thorough review of both mucormycosis in the general population and the immunocompromised; it focuses on emerging species of Mucorales and on molecular testing strategies.

  5. Almyroudis NG, Sutton DA, Linden P, et al. Zygomycosis in solid organ transplant recipients in a tertiary transplant center and review of the lieterature. Am J Transplant. 2006;6:2365–74.

    Article  CAS  Google Scholar 

  6. Prakash H, Chakrabarti A. Epidemiology of mucormycosis in India. Microorganisms. 2021;9(3):523.

  7. Bassetti M, Bouza E. Invasive mould infections in the ICU setting: complexities and solutions. J Antimicrob Chemother. 2017;72(suppl_1):i39-i47.

  8. Lax C, Pérez-Arques C, Navarro-Mendoza MI, Cánovas-Márquez JT, Tahiri G, Pérez-Ruiz JA, Osorio-Concepción M, Murcia-Flores L, Navarro E, Garre V, Nicolás FE. Genes, pathways, and mechanisms involved in the virulence of mucorales. Genes (Basel). 2020;11(3):317.

    Article  CAS  Google Scholar 

  9. Alfano G, Fontana F, Francesca D, Assirati G, Magistri P, Tarantino G, Ballarin R, Rossi G, Franceschini E, Codeluppi M, Guaraldi G, Mussini C, Di Benedetto F, Cappelli G. Gastric mucormycosis in a liver and kidney transplant recipient: case report and concise review of literature. Transplant Proc. 2018;50(3):905–9.

    Article  CAS  Google Scholar 

  10. Skiada A, Lass-Floerl C, Klimko N, Ibrahim A, Roilides E, Petrikkos G. Challenges in the diagnosis and treatment of mucormycosis. Med Mycol. 2018;56(suppl_1):93–101.

  11. Agrawal R, Yeldandi A, Savas H, Parekh ND, Lombardi PJ, Hart EM. Pulmonary mucormycosis: risk factors, radiologic findings, and pathologic correlation. Radiographics. 2020;40(3):656–66.

    Article  Google Scholar 

  12. Aguilar C, Husain S, Lortholary O. Recent advances in understanding and managing infectious diseases in solid organ transplant recipients. F1000Res. 2018;7:F1000 Faculty Rev-661.

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Author information

Authors and Affiliations

  1. Department of Medicine, Baylor University Medical Center, Dallas, TX, USA

    Alejandro Perez Davila & Cedric Spak

  2. Texas Centers for Infectious Disease Associates, Baylor University Medical Center, Dallas, TX, USA

    Cedric Spak & Edward A. Dominguez

  3. Methodist Transplant Specialists, Methodist Dallas Medical Center, 1411 N Beckley Ave, Suite 268, Dallas, TX, USA

    Edward A. Dominguez

Authors
  1. Alejandro Perez Davila
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  2. Cedric Spak
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  3. Edward A. Dominguez
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Corresponding author

Correspondence to Edward A. Dominguez.

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The authors declare no competing interests.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Fungal Infections in Transplantation

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Davila, A.P., Spak, C. & Dominguez, E.A. Mucormycosis in Solid Organ Transplant. Curr Fungal Infect Rep 16, 70–73 (2022). https://doi.org/10.1007/s12281-022-00431-3

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  • DOI: https://doi.org/10.1007/s12281-022-00431-3

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