Management of Pulmonary Mucormycosis After Orthotopic Heart Transplant: A Case Series. 2021

Michael C Hill, and Mark N Belkin, and Phillip McMullen, and Jessica J Pillarella, and Greg P Macaluso, and Adam N Treitman, and Pat S Pappas, and Antone J Tatooles, and William G Cotts, and Ambar A Andrade, and Gene Kim, and Nikhil Narang
Division of Cardiology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois.

Invasive pulmonary mucormycosis is a potentially fatal infection that can occur in immunosuppressed patients such as those who have undergone orthotopic heart transplant (OHT). High-dose intravenous antifungal agents, including amphotericin B, are generally accepted as the first-line medical treatment, with prompt surgical resection of lesions if feasible. The body of evidence guiding treatment decisions, however, is sparse, particularly regarding adjustment of immunosuppression during acute infection and long-term recovery. We present 2 cases of patients with pulmonary mucormycosis occurring within the first 6 months after OHT, both of whom successfully recovered after appropriate medical and surgical treatment, and we highlight differences in immunosuppression management strategies for this life-threatening condition.

UI MeSH Term Description Entries
D009091 Mucormycosis Infection in humans and animals caused by any fungus in the order MUCORALES (e.g., RHIZOPUS; MUCOR; CUNNINGHAMELLA; APOPHYSOMYCES; ABSIDIA; SAKSENAEA and RHIZOMUCOR) There are many clinical types associated with infection including central nervous system, lung, gastrointestinal tract, skin, orbit and paranasal sinuses. In humans, it usually occurs as an OPPORTUNISTIC INFECTION. Mucorales Infection,Mucorales Infections,Mucormycoses,Infection, Mucorales,Mucormycose
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000666 Amphotericin B Macrolide antifungal antibiotic produced by Streptomyces nodosus obtained from soil of the Orinoco river region of Venezuela. Amphocil,Amphotericin,Amphotericin B Cholesterol Dispersion,Amphotericin B Colloidal Dispersion,Fungizone
D000935 Antifungal Agents Substances that destroy fungi by suppressing their ability to grow or reproduce. They differ from FUNGICIDES, INDUSTRIAL because they defend against fungi present in human or animal tissues. Anti-Fungal Agents,Antifungal Agent,Fungicides, Therapeutic,Antibiotics, Antifungal,Therapeutic Fungicides,Agent, Antifungal,Anti Fungal Agents,Antifungal Antibiotics
D016027 Heart Transplantation The transference of a heart from one human or animal to another. Cardiac Transplantation,Grafting, Heart,Transplantation, Cardiac,Transplantation, Heart,Cardiac Transplantations,Graftings, Heart,Heart Grafting,Heart Graftings,Heart Transplantations,Transplantations, Cardiac,Transplantations, Heart
D016867 Immunocompromised Host A human or animal whose immunologic mechanism is deficient because of an immunodeficiency disorder or other disease or as the result of the administration of immunosuppressive drugs or radiation. Immunosuppressed Host,Immunocompromised Patient,Host, Immunocompromised,Host, Immunosuppressed,Hosts, Immunocompromised,Hosts, Immunosuppressed,Immunocompromised Hosts,Immunocompromised Patients,Immunosuppressed Hosts,Patient, Immunocompromised,Patients, Immunocompromised

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