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

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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

ASJC Scopus subject areas

  • Gastroenterology

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