Management of pulmonary mucormycosis after orthotopic heart transplant: A case series

Authors

• Michael C. Hill, Division of Cardiology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
• Mark N. Belkin, Section of Cardiology, Department of Medicine.Follow
• Phillip McMullen, Department of Pathology, University of Chicago Medical Center, Chicago, Illinois.
• Jessica J. Pillarella, Division of Cardiology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois; Division of Cardiology.
• Greg P. Macaluso, Division of Cardiology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois; Division of Cardiology.
• Adam N. Treitman, Division of Infectious Disease.
• Pat S. Pappas, Advocate Aurora HealthFollow
• Antone J. Tatooles, Advocate Aurora HealthFollow
• William G. Cotts, Division of Cardiology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois; Division of Cardiology.Follow
• Ambar A. Andrade, Division of Cardiology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois; Division of Cardiology.Follow
• Gene Kim, Section of Cardiology, Department of Medicine.
• Nikhil Narang, Division of Cardiology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois; Division of Cardiology. Electronic address: nikhil.narang@aah.org.

Recommended Citation

Hill MC, Belkin MN, McMullen P 2nd, et al. Management of Pulmonary Mucormycosis After Orthotopic Heart Transplant: A Case Series. Transplant Proc. 2021;53(10):3051-3055. doi:10.1016/j.transproceed.2021.09.034

Affiliations

Advocate Christ Medical Center

Abstract

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.

Document Type

Article

PubMed ID

34772489