{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:25:05Z","timestamp":1763036705308},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,8,16]],"date-time":"2012-08-16T00:00:00Z","timestamp":1345075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2012,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Zygomycetes infection is associated with a high mortality in transplant populations. We describe a child with liver allograft <jats:italic><jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>hizopus oryzae<\/jats:italic> infection who was salvaged by liver re\u2010transplantation. A 10\u2010year\u2010old child presented with anastomotic bile leak that was repaired. A combined antibiotics and voriconazole regimen was introduced for <jats:italic><jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>scherichia coli<\/jats:italic> and <jats:italic><jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>andida krusei<\/jats:italic> growth in the peritoneal fluid. Despite broad antibiotic and antifungal coverage, the patient continued to have an ongoing infection. A follow\u2010up computed tomography scan 8\u00a0weeks later showed 2 liver abscesses infiltrating the stomach and the diaphragm, with splenic infarcts and pericardial effusion. Aspirated samples from the liver abscess and the pericardial fluid revealed <jats:italic><jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>. oryzae<\/jats:italic>. Immunosuppression was discontinued and an antifungal regimen combining amphotericin B, posaconazole, and caspofungin was introduced. After 3\u00a0weeks of treatment with control of the systemic signs of infection, a positron emission tomography showed the fluorescence stain limited to the liver. With infection confined to the liver, the child underwent liver re\u2010transplantation, splenectomy, and partial gastrectomy. Immunosuppression was reintroduced with recovery of the immune response observed by the <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 cells adenosine triphophate release (<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ylex<jats:sup>\u2122<\/jats:sup> <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>mmu<jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>now<jats:sup>\u00ae<\/jats:sup> assay) and posaconazole was continued for another year. At 3\u2010year follow\u2010up, the child maintained normal graft function. We conclude that discontinuation of immunosuppression combined with a modern antifungal regimen may allow salvage re\u2010transplantation in patients with liver mucormycosis.<\/jats:p>","DOI":"10.1111\/j.1399-3062.2012.00776.x","type":"journal-article","created":{"date-parts":[[2012,8,16]],"date-time":"2012-08-16T10:11:11Z","timestamp":1345111871000},"source":"Crossref","is-referenced-by-count":12,"title":["Mucormycosis in a liver allograft: salvage re\u2010transplantation and targeted immunosuppressive management"],"prefix":"10.1111","volume":"14","author":[{"given":"M.","family":"Gurevich","sequence":"first","affiliation":[{"name":"Department of Transplantation Rabin Medical Center Beilinson Hospital Petach\u2010Tiqwa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Levi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service Schneider Children's Medical Center Petach\u2010Tiqwa 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