{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:17:56Z","timestamp":1790983076853,"version":"4.1.0"},"reference-count":34,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Fungi","JoF"],"abstract":"<jats:p>Donor-derived infections (DDIs), particularly fungal DDIs, are uncommon but serious complications of solid organ transplantation. We report a case of a 52-year-old woman who underwent deceased donor kidney transplantation complicated by probable donor-derived Candida albicans candidemia with native aortic valve endocarditis, managed medically with prolonged echinocandin therapy followed by suppressive fluconazole. Approximately 14 months post-transplant, she developed progressive rhino-orbital mucormycosis due to Rhizopus oryzae, requiring extensive surgical debridement and prolonged antifungal therapy. Initial treatment with liposomal amphotericin B was limited by nephrotoxicity, prompting transition to isavuconazole for long-term management. Immunosuppression was discontinued to control infection, resulting in graft failure. This case illustrates the complex interplay between donor-derived infection, antifungal exposure, and immunosuppression in transplant recipients. It highlights the potential contribution of antifungal selective pressure to breakthrough mold infections and underscores the importance of early recognition, aggressive multidisciplinary management, and individualized antifungal strategies in this high-risk population.<\/jats:p>","DOI":"10.3390\/jof12080621","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T07:58:23Z","timestamp":1787126303000},"page":"621","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Dual Invasive Fungal Infections After Kidney Transplantation: A Case Report"],"prefix":"10.3390","volume":"12","author":[{"given":"Layan","family":"Akkielah","sequence":"first","affiliation":[{"name":"Department of Medicine and Infectious Diseases, Western University, London Health Sciences Centre, London, ON N6A 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Bishara","sequence":"additional","affiliation":[{"name":"Department of Medicine and Infectious Diseases, Western University, London Health Sciences Centre, London, ON N6A 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh J.","family":"Sowerby","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON N6A 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8641-9579","authenticated-orcid":false,"given":"John","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6736-603X","authenticated-orcid":false,"given":"Matthew A.","family":"Weir","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"},{"name":"Department of Epidemiology and Biostatistics, Western University, London, ON N6A 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6030-8539","authenticated-orcid":false,"given":"Laila","family":"Alshafai","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Diagnostic Neuroradiologist, Head and Neck Imaging, Mount Sinai Hospital, University Health Network, Toronto, ON M5G 1X5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Silverman","sequence":"additional","affiliation":[{"name":"Department of Medicine and Infectious Diseases, Western University, London Health Sciences Centre, London, ON N6A 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2410-6788","authenticated-orcid":false,"given":"Mohammad Reza","family":"Rahimi Shahmirzadi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Infectious Diseases, Western University, London Health Sciences Centre, London, ON N6A 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1111\/ajt.16178","article-title":"Ten years of donor-derived disease: A report of the disease transmission advisory committee","volume":"21","author":"Kaul","year":"2021","journal-title":"Am. 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