Successful Oral Isavuconazole Monotherapy for Invasive Pulmonary Mucormycosis in Kidney Transplant Recipients: Case Reports and Literature Review

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-03-12 DOI:10.1016/j.transproceed.2025.02.047

Zeng-Jie Wang , Jue Zhang , Yun-Ying Shi

引用次数: 0

Abstract

This study represents 2 cases of kidney transplant recipients (KTRs) with invasive pulmonary Rhizopus infection, successfully treated with oral isavuconazole monotherapy without lobectomy. The rapid detection via mNGS of bronchoalveolar lavage fluid enabled early diagnosis and timely intervention, resulting in complete recovery and stable graft function. The literature review revealed a 16.7% mortality rate among 13 cases, with a higher mortality rate of 66.7% among patients receiving antifungal treatment without surgical intervention. Our findings underscore the efficacy of isavuconazole as a first-line monotherapy, characterized by lower nephrotoxicity and fewer interactions with immunosuppressants, and emphasize the crucial role of metagenome next-generation sequencing (mNGS) in early diagnosis of invasive mucormycosis in high-risk population.

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口服异维康唑单药治疗肾移植受者侵袭性肺毛霉菌病的成功：病例报告和文献综述。

本研究报告了2例肾移植受者（KTRs）侵袭性肺根霉感染，经口服异维康唑单药治疗成功，未行肺叶切除术。通过mNGS快速检测支气管肺泡灌洗液，实现了早期诊断和及时干预，移植物功能完全恢复和稳定。文献回顾显示，13例患者的死亡率为16.7%，而未经手术治疗的抗真菌治疗患者的死亡率为66.7%。我们的研究结果强调了isavuconazole作为一线单药治疗的有效性，其特点是肾毒性较低，与免疫抑制剂的相互作用较少，并强调了宏基因组新一代测序（mNGS）在高危人群侵袭性毛霉病早期诊断中的关键作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.