Durable cure of mucormycosis involving allograft and native lungs

Among the spectrum of fungi causing disease in lung allograft recipients, f ungi in the order Mucorales represent uncommon pathogens. Lung transplant p atients, however, often possess more than one risk factor for development o f life-threatening mucormycosis. We describe a unique case of pulmonary muc ormycosis involving both the allograft and the native lungs, in a single lu ng transplant recipient with steroid-induced diabetes. Extended intravenous amphotericin B and oral fluconazole therapy, reduction of immunosuppressio n, and blood glucose control achieved a durable cure without the need for s urgical intervention. Early diagnosis with prompt initiation of multiagent antifungal therapy, prolonged continuation of antifungal therapies, and ame lioration of contributing conditions are important elements of the treatmen t strategy that led to successful resolution of the infection.