Wound Infection with an Unusual Pathogen after Liver Transplantation.

Case Reports in Transplantation Pub Date : 2020-04-02 eCollection Date: 2020-01-01 DOI:10.1155/2020/8396507
Sara Ghaderkhani, Zahra Ahmadinejad, Habibollah Dashti, Masoomeh Safaei, Fereshteh Ghiasvand
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引用次数: 2

Abstract

Mucormycosis is a rare and highly invasive fungal infection caused by Mucorales fungi of the class Zygomycetes. Cutaneous mucormycosis typically has a good survival rate when diagnosed early. In this report, we presented a patient with surgical site mucormycosis after liver transplant surgery. Our patient was a 50-year-old man with cirrhosis due to nonalcoholic steatohepatitis who received liver transplant from a deceased donor. On the 8th day of transplant, the patient had fever and purulent discharge from the surgical site. The wound became black and necrotic in the next day. A microbiologic study showed mycelium in wound culture. The smear of the discharge was positive for aseptate hyphae, and the report of fungal culture revealed Rhizopus sp. In the histopathologic examination, mucormycosis was confirmed. The combination of antifungal and surgical debridement was a successful treatment in this case. Cutaneous fungal infections should be considered in the differential diagnosis of any nonhealing or black scar-infected wound that does not respond to broad-spectrum antibiotics.

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肝移植术后伤口感染的一种罕见病原体。
毛霉菌病是由接合菌纲毛霉菌引起的一种罕见的高度侵袭性真菌感染。当早期诊断时,皮肤毛霉病通常具有良好的生存率。在此报告中,我们报告了一例肝移植术后发生手术部位毛霉菌病的患者。我们的病人是一位50岁的男性,患有非酒精性脂肪性肝炎导致的肝硬化,他接受了来自已故供者的肝移植。移植第8天,患者出现发热和手术部位脓性分泌物。第二天,伤口开始发黑坏死。一项微生物学研究显示伤口培养中有菌丝体。分泌物涂片无菌菌丝阳性,真菌培养报告为根霉。组织病理学检查证实为毛霉病。在这个病例中,联合使用抗真菌药和外科清创是一种成功的治疗方法。皮肤真菌感染应考虑在鉴别诊断任何未愈合或黑色疤痕感染的伤口,没有反应的广谱抗生素。
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