Rhinocerebral zygomycosis after liver transplantation: Therapeutic challenges in recipients treated for recurrent hepatitis C

Research output: Contribution to journalArticle

Abstract

We report on a 40-year-old male liver recipient who developed a usually highly fatal rhinocerebral zygomycosis while being treated for recurrent hepatitis C. Risk factors included immunosuppressive therapy, episodes of neutropenia and anemia, chronic liver graft dysfunction, posttransplant diabetes, and intermittent renal insufficiency. Aggressive treatment, including maxillary débridement and orbital exenteration, reduction of immunosuppression, as well as prolonged intravenous antifungal therapy, was successful. There was no zygomycosis recurrence during the four-year follow-up. Graft function could be maintained and recurrent hepatitis C histologic findings improved. The severe life-threatening infection encountered in our liver recipient with recurrent hepatitis C suggests that particular attention must be paid to avoiding overimmunocompromising this large and expanding recipient group. If these patients develop zygomycosis, early diagnosis and aggressive treatment are key to their survival.

Original languageEnglish (US)
JournalPractical Gastroenterology
Volume32
Issue number11
StatePublished - Nov 2008

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Zygomycosis
Hepatitis C
Liver Transplantation
Transplants
Liver
Therapeutics
Immunosuppressive Agents
Neutropenia
Immunosuppression
Renal Insufficiency
Liver Diseases
Anemia
Early Diagnosis
Recurrence
Survival
Infection

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Rhinocerebral zygomycosis after liver transplantation: Therapeutic challenges in recipients treated for recurrent hepatitis C",
abstract = "We report on a 40-year-old male liver recipient who developed a usually highly fatal rhinocerebral zygomycosis while being treated for recurrent hepatitis C. Risk factors included immunosuppressive therapy, episodes of neutropenia and anemia, chronic liver graft dysfunction, posttransplant diabetes, and intermittent renal insufficiency. Aggressive treatment, including maxillary d{\'e}bridement and orbital exenteration, reduction of immunosuppression, as well as prolonged intravenous antifungal therapy, was successful. There was no zygomycosis recurrence during the four-year follow-up. Graft function could be maintained and recurrent hepatitis C histologic findings improved. The severe life-threatening infection encountered in our liver recipient with recurrent hepatitis C suggests that particular attention must be paid to avoiding overimmunocompromising this large and expanding recipient group. If these patients develop zygomycosis, early diagnosis and aggressive treatment are key to their survival.",
author = "Rahim, {Nazir A.} and Christoph Troppmann and Kanat Ransibrahmanakul and Cohen, {Stuart H} and John McVicar and Christopher Bowlus and Lorenzo Rossaro",
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T2 - Therapeutic challenges in recipients treated for recurrent hepatitis C

AU - Rahim, Nazir A.

AU - Troppmann, Christoph

AU - Ransibrahmanakul, Kanat

AU - Cohen, Stuart H

AU - McVicar, John

AU - Bowlus, Christopher

AU - Rossaro, Lorenzo

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AB - We report on a 40-year-old male liver recipient who developed a usually highly fatal rhinocerebral zygomycosis while being treated for recurrent hepatitis C. Risk factors included immunosuppressive therapy, episodes of neutropenia and anemia, chronic liver graft dysfunction, posttransplant diabetes, and intermittent renal insufficiency. Aggressive treatment, including maxillary débridement and orbital exenteration, reduction of immunosuppression, as well as prolonged intravenous antifungal therapy, was successful. There was no zygomycosis recurrence during the four-year follow-up. Graft function could be maintained and recurrent hepatitis C histologic findings improved. The severe life-threatening infection encountered in our liver recipient with recurrent hepatitis C suggests that particular attention must be paid to avoiding overimmunocompromising this large and expanding recipient group. If these patients develop zygomycosis, early diagnosis and aggressive treatment are key to their survival.

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