Successful treatment of massive lower gastrointestinal bleeding caused by mixed infection of cytomegalovirus and mucormycosis in a renal transplant recipient

We describe a case of lower gastrointestinal bleeding due to mixed infectio n of cytomegalovirus (CMV) and mucormycosis in a renal transplant recipient . A 33-year-old male received renal transplantation and his clinical course was uneventful, On the 18th postoperative day, acute rejection was develop ed and this was treated with high-dose methylprednisolone and OKT3, During antirejection treatment, sudden onset massive hematochezia was developed, E mergency colonofibroscopy revealed multiple colonic ulcers and pathologic f indings were consistent with mucormycosis and CMV infection. The patient wa s successfully treated with amphotericin B (1.0-1.5 mg/kg) and ganciclovir (62.5-125 mg/day) for 5 weeks, To our knowledge, this is the first report s howing coexistence of mucormycosis and CMV in the colon ulcer base, This fi nding suggests that CMV infection may trigger fungal infection in the patho genesis of colonic ulcer, Copyright (C) 2001 S. Karger AG, Basel.