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RACS ASC 2024

Phaeohyphomycosis in Kidney Transplant Recipients: Highlighting the Importance of Early Recognition and Surgical Debridement

Poster

Presentation Description

Institution: Westmead Hospital - NSW, Australia

Purpose: Fungal infections are a recognized complication of immunosuppression in solid organ transplant recipients. Phaeohyphomycoses are fungal infections caused by a diverse group of dematiaceous fungi. Methodology: We share the learning points from two Australian cases of phaeohyphomycosis secondary to Phaeacreomonium species (spp). A literature review was performed using Medline, Embase, and Google Scholar to identify this condition among kidney transplant recipients. Results. Alongside the two cases reported in this article, a total of seventeen cases were identified in the literature. Phaeacremonium spp is ubiquitous in humid and temperate flora, including Australia. Minor trauma is likely the source of inoculation in most cases and diagnosis is often delayed. Presently, no guidelines for management exist, given the rarity of this condition. MRI and tissue sampling with fungal-specific culture, staining and PCR testing were essential diagnostic tools for these cases. Most known cases have been treated with surgical debulking combined with long-course antifungal therapy. Early involvement with the original transplant unit is highly recommended to aid in timely diagnosis and avoid issues relating to drug–drug interactions with concurrent immunosuppressive agents. Conclusion. This paper describes two Australian cases of phaeohyphomycosis in kidney transplant recipients. A high index of suspicion, especially in the immunosuppressed, is essential for timely diagnosis in kidney transplant recipients. There are several diagnostic and therapeutic challenges that remain with this condition.

Speakers

Authors

Authors

Dr Rowan Klein Nulend - , Dr Animesh Singla - , Dr Priya Garg - , Dr Juanita Chui - , Dr David Pham - , Dr Zachary Webb-Harvey - , Dr Catriona Halliday - , Dr Ramesh De Silva - , Dr Ahmer Hameed - , Dr Taina Lee - , Professor Germaine Wong - , Professor Henry Pleass -