Infectious Dis. Medical News about Mucormycosis Lung Transplantation

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Ulcerative leg nodules in a transplant recipient
Cleveland Clinic Journal of Medicine, 10/16/09

Chua A–P et al. – A 66–year–old white man presents with a 1–month history of two nontender, nonpruritic skin lesions on his leg 3 weeks after undergoing bilateral lung transplantation for idiopathic pulmonary fibrosis. Except for transient lymphopenia, the postoperative course has been uneventful, with no episodes of rejection. Immunosuppressive drugs include tacrolimus (Prograf) and steroids. He has a history of insulin–dependent diabetes mellitus, and no history of significant trauma to his legs. Other than the skin lesions, he feels well and has no systemic symptoms. He has no history of iron overload or deferoxamine (Desferal) therapy...Mucormycosis is an invasive infection caused by fungi of a variety of genera (Rhizopus, Rhizomucor, Mucor, Absidia, Apophysomyces, Cunninghamella, Saksenaea, Conidiobolus, and Basidiobolus species) belonging to the class Zygomycetes in the order Mucorales. The best treatment outcomes of primary cutaneous mucormycosis are achieved with both complete excision and debridement of necrotic tissue and systemic antifungal therapy. Amphotericin B in conventional form (Fungizone) and liposomal form (AmBisome) and posaconazole (Noxafil)11–12 are effective.

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