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A Rare Case of Pulmonary Coinfection by Lichtheimia ramosa and Aspergillus fumigatus in a Patient With Delayed Graft Function After Renal Transplantation.

Abstract
Pulmonary coinfection with Mucor and Aspergillus species has not been reported in organ transplant recipients. Here, we report a rare case of pulmonary coinfection with invasive fungal species in a renal transplant recipient with delayed graft function. The patient was first treated with a regime containing voriconazole, but the infection only worsened. Then, bronchoalveolar lavage fluid culture and internal transcribed spacer region sequencing were performed, and simultaneous pulmonary infection by Lichtheimia ramosa and Aspergillus fumigatus was clearly diagnosed. Susceptibility testing determined that the fungi were sensitive to amphotericin B and posaconazole. Therefore, a therapeutic regime containing posaconazole and amphotericin B liposome, which are less toxic to the kidney, was planned and resulted in resolution of the infectious symptoms. The present case demonstrates the importance of identifying fungal pathogens early and definitively, determining the effective anti-fungal medications, and administering the properly planned therapeutic regime in a timely manner to treat cases of coinfection in transplant recipients.
AuthorsQ Zhang, H Liu, S Qiu, W Wang, L Yang, H Chen, X Chen, Z Shen
JournalTransplantation proceedings (Transplant Proc) Vol. 51 Issue 2 Pg. 551-555 (Mar 2019) ISSN: 1873-2623 [Electronic] United States
PMID30879588 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2018. Published by Elsevier Inc.
Chemical References
  • Antifungal Agents
  • Triazoles
  • liposomal amphotericin B
  • posaconazole
  • Amphotericin B
Topics
  • Amphotericin B (therapeutic use)
  • Antifungal Agents (therapeutic use)
  • Aspergillosis (immunology)
  • Aspergillus fumigatus
  • Coinfection
  • Delayed Graft Function
  • Humans
  • Immunocompromised Host
  • Kidney Transplantation (adverse effects)
  • Male
  • Mucorales
  • Mucormycosis (drug therapy, immunology)
  • Respiratory Tract Infections (immunology, microbiology)
  • Triazoles (therapeutic use)

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