Rhizomucor hepatosplenic abscesses in a patient with renal and pancreatic transplantation

Ann R Coll Surg Engl. 2021 Apr;103(4):e131-e135. doi: 10.1308/rcsann.2020.7125. Epub 2021 Mar 8.

Abstract

Fungal infections are generally observed in immunosuppressed patients only, with a diagnostic challenge due to non-specific symptoms. For this reason, appropriate management may be delayed. This case report concerns a 36-year-old man with history of pancreas and kidney transplantation. He had chemotherapy for post-transplant B-cell lymphoma and presented with left upper abdominal pain and fever. Multiple investigations led to a final diagnosis of disseminated abdominal mucormycosis with multiple Rhizomucor abscesses in the liver, spleen and kidney transplant. Treatment was antifungal therapy and laparotomy with splenectomy, wedge resection of two fungal abscesses in segments II and IVb, and segmental left colic resection.

Keywords: Hepatic abscess; Immunosuppression; Mucorales; Multivisceral transplant; Rhizomucor; Splenic abscess.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Abscess / diagnosis*
  • Abdominal Abscess / etiology
  • Abdominal Abscess / surgery
  • Adult
  • Hepatectomy
  • Humans
  • Kidney Transplantation*
  • Liver Diseases / diagnosis
  • Liver Diseases / etiology
  • Liver Diseases / surgery
  • Male
  • Mucormycosis / diagnosis*
  • Mucormycosis / etiology
  • Mucormycosis / surgery
  • Pancreas Transplantation*
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / surgery
  • Rhizomucor / isolation & purification*
  • Splenectomy
  • Splenic Diseases / diagnosis
  • Splenic Diseases / etiology
  • Splenic Diseases / surgery