Colonic Mucormycosis Mimicking Ischemic Colitis in Kidney Transplant Recipient.
10.4285/jkstn.2016.30.2.98
- Author:
Hyun Woo KIM
1
;
Young Min YOON
;
Mi Ja LEE
;
Nam Gyu CHOI
;
Sung Pyo MOON
;
Na Ra YOON
;
Sun Ae HAN
;
Hyung Nam KIM
;
Jun Hyung LEE
;
Da Yeong KANG
;
Hee Jung AHN
;
Byung Chul SHIN
;
Hyun Lee KIM
;
Jong Hoon CHUNG
Author Information
1. Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea. bcshin@chosun.ac.kr
- Publication Type:Case Report
- Keywords:
Mucormycosis;
Kidney transplantation;
Ischemic colitis
- MeSH:
Abdominal Pain;
Antifungal Agents;
Colectomy;
Colitis, Ischemic*;
Colon*;
Colon, Ascending;
Diabetes Mellitus;
Diabetic Nephropathies;
Follow-Up Studies;
Gastrointestinal Tract;
Humans;
Hyphae;
Kidney Failure, Chronic;
Kidney Transplantation;
Kidney*;
Middle Aged;
Mucormycosis*;
Mucous Membrane;
Multiple Organ Failure;
Spores;
Tissue Donors;
Tomography, X-Ray Computed;
Transplant Recipients*
- From:The Journal of the Korean Society for Transplantation
2016;30(2):98-102
- CountryRepublic of Korea
- Language:English
-
Abstract:
Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Mucormycosis of the gastrointestinal tract manifests with features similar to ischemic colitis. A 48-year-old man with end-stage renal disease due to diabetic nephropathy underwent deceased donor kidney transplantation. He complained of abdominal pain and distension on postoperative day 17. A computed tomography (CT) scan revealed symmetrical wall thickening of the ascending colon, which was consistent with ischemic colitis. However, a follow-up CT scan showed a localized wall-off colon perforation in the hepatic flexure and segmental mural gas in the ascending colon. Microscopic examination obtained from a surgical specimen demonstrated numerous fungal hyphae and spores in the mucosa and submucosa. A total colectomy was performed, but the patient died 36 days later due to multiple organ failure, despite antifungal agents. Clinicians should be informed about fungal infection, such as colonic mucormycosis mimicking ischemic colitis, in kidney transplant patients with diabetes mellitus, and treatment should be initiated at the earliest.
