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Publication Type : Journal Article
Thematic Areas : Medical Sciences
Publisher : BMJ Case Rep
Source : BMJ Case Rep, Volume 2016 (2016)
Keywords : adult, Antifungal Agents, Entomophthorales, Fatal Outcome, Humans, Liver Diseases, liver transplantation, male, Zygomycosis
Campus : Kochi
School : School of Medicine
Department : Gastrointestinal Surgery, Anaesthesiology
Year : 2016
Abstract : A 44-year-old man with hepatitis B virus (HBV)-related cirrhosis underwent living donor liver transplantation at our institute. Induction of immunosuppression was achieved with basiliximab, due to deranged renal function, and maintained with prednisolone, tacrolimus and mycophenolate mofetil. The intraoperative and immediate postoperative periods were fairly uneventful. A duplex scan, taken during the third week post-transplantation due to sudden rise in liver enzymes, revealed multifocal hypoechoic lesions in the graft liver with normal Doppler parameters. Multidetecor computed tomography (MDCT) showed multiple hypodense vessel-sparing lesions in the graft liver. Cultures from the aspirate grew filamentous fungi identified as Basidiobolus ranarum species. Despite multiple broad spectrum antifungal infusions including liposomal amphotericin, itraconazole, caspofungin and posaconazole, serial sonography showed the hepatic lesions increasing in size, and involving segments V, VI and VII. The patient developed severe liver dysfunction ultimately progressing to sepsis, multiorgan dysfunction and death.
Cite this Research Publication : P. Sethi, Balakrishnan, D., Surendran, S., and Mohamed, Z. Umer, “Fulminant zygomycosis of graft liver following liver transplantation.”, BMJ Case Rep, vol. 2016, 2016.