TABLE 1.
Characteristics of the two kidney transplant patients with mucormycosis
| Case 1 | Case 2 | |
|---|---|---|
| Gender/age | M/62 y | M/48 y |
| Underlying diseases |
Arterial hypertension Diabetes mellitus II (HbAc1 9.6%) End‐stage renal disease with kidney transplant (IS: tacrolimus, prednisone) Disseminated cryptococcosis (2019) Ischemic heart disease |
Arterial hypertension End‐stage renal disease with 4 kidney transplant (IS: prednisone, mycophenolate and tacrolimus). Hypothyroidism |
| COVID‐19 severity | Severe (bilateral pneumonia requiring non‐invasive mechanical ventilation) |
Moderate (FiO2 28%) |
| Systemic corticosteroid therapy for COVID‐19 | Dexametasone 6 mg daily for 10 d | Prednisone 20 mg daily (administered as immunosuppressant) |
| Concomitant treatment |
Ceftriaxone Azithromycin |
Hydroxychloroquine Azithromycin Lopinavir/ritonavir Tocilizumab |
| Time between diagnosis of COVID‐19 and mucormycosis | 1 wk | 3 wk |
| Mucormycosis associated risk factors | Diabetes, previous fungal disease, immunosuppression, steroid therapy | Immunosuppression, steroid therapy |
| Presentation | Rhinosinusal | Musculoskeletal |
| Diagnostics | Culture from the necrotic tissue | Culture from the necrotic tissue |
| Specie aisled | Rizopus oryzae | Lichtheimia ramose |
| Antifungal treatment | Liposomal amphotericin B, isavuconazole and subsequently posaconazole | Liposomal amphrotericin B and isavuconazol |
| Surgical debridement | 7 times | 3 times |
| Outcome | Alive | Alive |