Pulmonary Rhizopus infection in a diabetic renal transplant recipient

Infectious complications after renal transplantation remain a major cause o f morbidity and mortality. Mucormycosis is a rare infection in renal transp lant recipients; however, mortality is exceedingly high. Risk factors predi sposing to this disease include prolonged neutropenia, diabetes, and patien ts who are immunosuppressed (Singh N, Gayowski T, Singh J, Yu LV. Invasive gastrointestinal zygomycosis in a liver transplant recipient: case report a nd review of zygomycosis in solid-organ transplant recipients, Clin Infect Dis 1995: 20: 617). Life-threatening infections can occur, as this fungus h as the propensity to invade blood vessel endothelium, resulting in hematolo gical dissemination. We report a case of cavitary Rhizopus lung infection, 2 months after renal transplantation, where the patient was treated success fully with Amphotericin B and surgical resection of the lesions with preser vation of his allograft function. In this era of intensified immunosuppress ion, we may see an increased incidence of mucormycosis in transplant popula tion. Invasive diagnostic work-up is mandatory in case of suspicion; Amphot ericin B and, in selected cases, surgical resection are the mainstays of th erapy.