Concurrent Pulmonary Aspergillus fumigatus and Mucor Infection in a Cardiac Transplant Recipient: A Case Report

• Published in: Transplantation proceedings Vol. 45; no. 2; pp. 792 - 797
• Main Authors: Webb, B.J, Blair, J.E, Kusne, S, Scott, R.L, Steidley, D.E, Arabia, F.A, Vikram, H.R
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2013
• Subjects: Air Microbiology; Antifungal Agents - therapeutic use; Cardiomyopathy, Dilated - surgery; Cyclonic Storms; Environmental Exposure; Heart Transplantation - adverse effects; Heart Transplantation - immunology; Humans; Immunosuppressive Agents - adverse effects; Invasive Pulmonary Aspergillosis - diagnosis; Invasive Pulmonary Aspergillosis - drug therapy; Invasive Pulmonary Aspergillosis - immunology; Invasive Pulmonary Aspergillosis - microbiology; Male; Middle Aged; Mucormycosis - diagnosis; Mucormycosis - drug therapy; Mucormycosis - immunology; Mucormycosis - microbiology; Pyrimidines - therapeutic use; Surgery; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Triazoles - therapeutic use; Voriconazole
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2012.03.056

Abstract Invasive fungal infections are a significant complication of solid organ transplantation. Here we report the first case of concurrent invasive pulmonary fungal infection caused by Aspergillus fumigatus and Mucor species in a heart transplant recipient. Polymicrobial mold infection is rare but should be considered in solid organ transplant recipients who fail to respond to initial antifungal therapy targeting a single organism. It is also of interest that in addition to potent immunosuppression and prolonged voriconazole therapy, possible airway fungal colonization following hurricane Katrina cleaning efforts might have contributed to this dual invasive mold infection.