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LETTER TO EDITOR
Year : 2006  |  Volume : 22  |  Issue : 4  |  Page : 381
 

Isolated renal allograft mucormycosis


1 Department of Urology, Command Hospital, Lucknow, India
2 Department of Nephrology, Command Hospital, Lucknow, India

Correspondence Address:
Aditya A Pradhan
Dept. of Urology, Command Hospital, Cantonmant, Lucknow - 226 002
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.29134

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How to cite this article:
Pradhan AA, Gadela S R, Kumar R. Isolated renal allograft mucormycosis. Indian J Urol 2006;22:381

How to cite this URL:
Pradhan AA, Gadela S R, Kumar R. Isolated renal allograft mucormycosis. Indian J Urol [serial online] 2006 [cited 2019 Jun 18];22:381. Available from: http://www.indianjurol.com/text.asp?2006/22/4/381/29134


Sir,

We read with interest the case report 'Isolated Mucormycosis of Renal Allograft.[1] The team is to be congratulated for having managed to salvage a case of documented renal allograft mucormycosis. A survey of data published on the matter reveals that only three cases out of a total of eight cases reported in the English literature have survived.[2],[3],[4]

An assessment of these cases shows that in all these cases fever and graft dysfunction have been the presentation. The diagnosis has often been retrospective, from the histopathological examination of the graft nephrectomy specimen. The course of events has been a fever which didn't respond to broad-spectrum antibiotics coupled with acute rejection which did not respond even to antibody treatment.

In this index case under consideration, the presentation was similar. What is not clear is, when there was no response to anti-rejection therapy was a second graft biopsy done to determine the cause of nonresponse to treatment?

It would also be enlightening to know what factors led the team to make the difficult decision of a graft nephrectomy, in the absence of any further information provided on this matter in the article.

Since azole antifungals are not effective treatment for mucormycosis the management problem in this setting appears to be taking a crucial decision to start early Amphotericin B and doing a graft nephrectomy as a life-saving measure.

 
   References Top

1.Radha S, Afroz T, Raju BV, Fernandez DK. Isolated mucormycosis of renal allograft. Indian J Urol 2006;22:144-5.  Back to cited text no. 1    
2.Ahmad M. Graft mucormycosis in a renal allograft recipient. J Nephrol 2005;18:783-6.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Minz M, Sharma A, Kashyap R, Udgiri N, Heer M, Kumar V, et al . Isolated renal allograft arterial mucormycosis: An extremely rare complication. Nephrol Dial Transplant 2003;18:1034-5.  Back to cited text no. 3    
4.Ponnappa BG, Singh S, Venugopal D, Korath MP, Jagadeesan K. Mucormycosis of Transplanted. Bombay Hosp J 2000;42:1034-5.  Back to cited text no. 4    




 

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