Disseminated Mucormycosis with Characteristic Gastric Ulcers and Extensive Intravascular Invasion after ABO-Incompatible Living-Donor Liver Transplantation: A Case Report - PubMed
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- #Mucormycosis
- #Liver Transplantation
- #Fungal Infection
- A male patient in his 50s with decompensated cirrhosis underwent ABO-incompatible living-donor liver transplantation.
- Postoperative complications included sepsis from infectious enteritis and two episodes of T cell-mediated rejection.
- On POD 39, esophagogastroduodenoscopy revealed multiple extensive gastric ulcers with dark brown mucosa, later diagnosed as mucormycosis.
- Rhizopus microsporus was isolated from gastric juice culture, confirming mucormycosis.
- Contrast-enhanced CT showed poor gastric wall enhancement and pulmonary nodules, indicating disseminated fungal infection.
- Despite treatment with liposomal amphotericin B, the patient developed septic shock and died on POD 63.
- Autopsy confirmed mucormycosis in multiple organs and extensive vascular invasion, including cobblestone-like fungal masses in the thoracic aortic intima.
- This case highlights breakthrough mucormycosis despite antifungal prophylaxis, emphasizing the need for early systemic evaluation in immunosuppressed patients.