Abstract: SA-PO1160
Early-Onset Colonic Mucormycosis with Hepatic Involvement in a Kidney Transplant Recipient
Session Information
- Transplantation: Clinical - Infectious Diseases
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Luo, Jing, Center for Kidney Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Liu, Yue, Center for Kidney Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Liu, Yangyan, Center for Kidney Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Cao, Kai, Center for Kidney Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Dai, Chunsun, Center for Kidney Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Gu, Min, Center for Kidney Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Cao, Hongdi, Center for Kidney Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
Introduction
Gastrointestinal mucormycosis is an extremely rare and often fatal angioinvasive infection in solid organ transplant recipients. Diagnosis is challenging, and effective treatment requires early combined medical and surgical intervention.
Case Description
A 41-year-old man developed hematochezia and persistent low-grade fever on day 11 after deceased-donor kidney transplantation. Initial blood metagenomic next-generation sequencing (mNGS), stool cultures, and abdominal CT were negative. On day 16, colonoscopy revealed multiple large, deep colonic ulcers; MRI showed a solitary liver abscess. Blood mNGS on day 18 identified Mucor indicus, and subsequent mNGS of ultrasound-guided liver aspirate confirmed co-infection with Mucor indicus and Rhizopus oryzae. Immunosuppression was reduced, and liposomal amphotericin B plus isavuconazole was initiated. Emergency laparoscopic partial hepatectomy was performed. Despite these measures, recurrent severe hematochezia on day 29 necessitated total colectomy with ileostomy; histology showed extensive transmural inflammation. The patient completed 18 weeks of antifungal therapy, achieved full clinical recovery, and maintained stable allograft function (serum creatinine 120–130 μmol/L).
Discussion
This case represents an unusually early post-transplant presentation of colonic mucormycosis with hepatic extension. Rapid identification by mNGS enabled prompt targeted antifungal therapy. Aggressive surgical debridement of infected liver and colon was decisive. Early molecular diagnosis, immediate administration of Mucorales-active antifungals, and complete surgical source control remain the cornerstones of management for this pernicious infection.