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. 2012 Nov 8;5(6):502–507. doi: 10.1093/ckj/sfs130

Table 1.

Clinico-pathological features of renal allograft mucormycosisa

S No. [ref no] Age/sex Aetiology/comorbidity Donor Post Tx Dx -days Clinico-laboratory manifestations Immunosuppression induction/ART Imaging USG/CT/Doppler Histo- Bx/Nx culture Treatment details Outcome
1 [17] 59/F CGN LURT-(India) 1 month Fever, RF, graft tend CMV + Candidial UTI Pred/CSA/AZA ART + (Bx ACR+) NA Graft biopsy Graft Nx + Ampho-B × 4 days Died
2 [7] 49 M CGN LRRT 18 months Fever, RF, graft tend CMV+ Pred/CSA ART + (Bx ACR +), ATG+ Enlarged graft Nx. Specimen Mucor Graft Nx + BSA Ampho-B −ve Died
3 [11] 42/M CGN LURT- (Egypt) 45 days Fever, RF, graft tend Pred/CSA/AZAART+ Enlarged graft CT/PG collection ↑ resistive index Graft biopsy Mucor Graft Nx + Ampho-B × 5 days Died
4 [22] 14/M B/L PUJ/Obstr uro LRRT 3 months RF, graft tend Pred/CSA/AZA ARTX2 (Bx ACR+) OKT3 + ATG, Enlarged graft (CT) Nx. specimen Mucor Graft Nx + Ampho-B × 5 days Died
5 [9] 42/M CGN LURT- (Egypt) 35 days RF fever ↑ TLC CMV PCR+ Pred/CSA/MMF ART + (Bx ACR+) Enlarged graft CT/PG collection ↑ resistive index Nx. specimen Disseminated Graft Nx + Ampho-B × 4 days Died
6 [9] 52/F DM LURT- (Egypt) 25 days Fever, RF, graft tend CMV PCR+ Pred/CSA/MMF Enlarged graft with air (CT) PG collection Nx. specimen Graft Nx + Ampho-B × 3 weeks TD 2.5 g Survived
7 [15] 18/F ADPKD, HCV LURT- (India) 25 days Fever, RF, graft tend HCV Pred/CSA/AZA ART (ACR+) Enlarged graft Graft biopsy Graft Nx + Ampho-B × 3 weeks TD 2.5 g Survived
8 [14] 52/M CGN LRRT 8 days Graft tend Pred/CSA/AZA induction-baxiliximab Peri-grafthematoma Nx. specimen Diagnosis PM Died
9 [23] 51/M HSP-nephritis ESRD LURT- (India) 2 months Fever, RF, graft tend disseminated-CMV + (allograft) Escherichia Coli UTI Pred/CSA/AZAART+ NA Graft biopsy Absidia corymbifera Graft Nx + alone Survived
10 [18] 30/F CGN LRRT 10 days Fever, RF, graft tend Pred/CSA/AZA ART+ CT-PG collection Graft biopsy Graft Nx + Ambisome × 4 days Died
11 [21] 53 M CGN LURT- (India) 2 months Odynophagia, RF CMV + (allograft) Aspergillosis lung Pred/CSA/AZA Thyroid abscess. Large kidney Autopsy disseminated Diagnosis PM Died
12 [12] 19 F NA DDRT 4 months Candida P aerogenosa K pneuminie Pred /AZA NA Nx. specimen Diagnosis PM Died
13 [8] 61 Mb CGN DDRT 7 days Fever, RF Pred/TAC induction with ATG CT-multiple air fluid levels Nx. specimen disseminated A. elegans Graft Nx + ABLC/AMB × 4 d Died
14 [8] 31 Fb CGN DDRT 12 days Fever RF, graft tend Pred/TAC induction with ATG CT-peri-graft fat stranding Nx. Specimen A. elegans Graft Nx + ABLC/Amb × 1 m (=40 g) Survived
15 [24] 31 M B/L PUJ/Obstr uro DDRT 2 months Graft tend Hematuria Pred/CSA/AZA ART+ US graft swelling Nx. specimen Graft Nx + Ampho-B Survived
16 [24] 58 F ADKD LURT- (India) 9 months Fever RF, graft tend UTI Org Pred/CSA/AZA ART+ NA Nx. specimen Graft Nx + Ampho-B × 5 weeks Survived
17 [19] 22 F CGN LRRT 2 months Fever RF graft tend UTI E. coli CSA MMF PRED Enlarged graft ↑ resistive index Graft biopsy Graft NX + AMPHO-B × 4 days Died
18 [20] 52 M CGN DDRT 2 months Fever RF graft tend Induction- baxiliximab and ART CSA, Pred + OKT3 no response + (ACR 2) Enlarged graft ↑ resistive index Nx. specimen Graft Nx + Ampho-B × 6 weeks dose 2 g Survived
19 [16] 62 M DM LURT- Pakistan 3 weeks Fever, RF PRED CSA MMF NIGERIAN IN USA Lurt Pakistan Enlarged graft, Hydronephrosis ureteral stenosis Graft biopsy Culture Mucor Graft Nx + Ampho-B + D 6 weeks Posaconazole Survived
20 [13] 42 M DM LRRT 1 month Fever, graft tend. RF PRED CSA MMF Absent USG enlarged Graft Graft Bx Graft Nx + Ampho-B × 7 days Died
21 [25] 59 M HCC, Liver Tx 10 yrs back DDRT 6 weeks Incision site infection. Graft Tend. RF PRED TAC MMF induction with ATGAM NA Graft biopsy Graft Nx + liposome AmB Survived
22 [10] 18 M CGN LRRT 1 month Fever, graft tend. RF PRED TAC MMF NA Renal artery thrombosis Nx Specimen Graft Nx + Ampho-B+ Died
23 46 M DM LURT- (India) 2 months Fever RF graft tend PRED CSA MMF Enlarged graft Graft biopsy Graft Nx + Ampho-BX4 weeks Survived
24 59/M CGN LURT- (India) 14 days Fever RF graft tend CMV + UTI (pseudo) Pred/CSA/AZA Enlarged graft PG collection Hypodense lesion on CT Graft biopsy + Nx Specimen Graft Nx + Ampho-B × 4 weeks Survived

aPred, prednisolone; AZA, azathioprine; MMF, mycoiphenolate; CSA, cyclosporine; TAC, Tacrolimus. Unpublished cases: LURD, live unrelated renal transplantation; LRRD, live related renal transplantation; NA, information not available; ART, anti-rejection treatment; PG, perigraft; Nx, nephrectomy.

bReceived kidney from the same donor.