Abstract
IntroductionCutaneous mucormycosis is a rare entity related to kidney transplantation. It usually presents with ecthyma-like lesions and black necrotic cellulitis. We report an unusual case of primary cutaneous mucormycosis presenting as erythema-nodosum-like lesions in a woman who had received a renal transplant.Case presentationA 49-year-old woman with diabetes received a living-unrelated kidney transplant. Her clinical course was uneventful for the first six months after transplantation. She then developed multiple, painful, erythema-nodosum-like lesions on her right leg and thigh following an episode of minor trauma. Mucormycosis was diagnosed by skin biopsy. Microscopic examination also showed panniculitis. The patient was treated successfully with amphotericin B and surgical resection. To our knowledge, this is the first description of primary cutaneous mucormycosis with erythema-nodosum-like lesions and panniculitis after renal transplantation.ConclusionCutaneous mucormycosis should be considered in the differential diagnosis when a kidney transplant recipient develops erythema-nodosum-like lesions with panniculitis.
Highlights
Cutaneous mucormycosis is a rare entity related to kidney transplantation
Cutaneous mucormycosis should be considered in the differential diagnosis when a kidney transplant recipient develops erythema-nodosum-like lesions with panniculitis
Mucormycosis is a rare but potentially lethal fungal infection that can develop in renal allograft recipients
Summary
Mucormycosis is a rare but potentially lethal fungal infection that can develop in renal allograft recipients. A 49-year-old woman who had developed end-stage renal disease as a result of diabetes and had been on maintenance CAPD (continuous ambulatory peritoneal dialysis) for 22 months underwent live-unrelated kidney transplantation in April 2006. Her clinical course was uneventful for the first six months after transplantation and she did not have any rejection episodes. Serum biochemistry showed her creatinine was 1.1 mg/dL, her fasting blood sugar was 191 mg/dL, her uric acid was 2.6 mg/dL and her lactate dehydrogenase was 625 IU/L She was negative for cytomegalovirus (CMV) IgM, but positive for CMV IgG, which had been positive prior to pretransplantation. Following cessation of amphotericin B, her serum creatinine concentration decreased to 1.1 mg/dL and remained stable
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