Zygomycetes (Apophysomyces elegans)

Record number: 
34
Adverse Occurrence type: 
MPHO Type: 
Time to detection: 
9 days
Alerting signals, symptoms, evidence of occurrence: 
Donor: fever followed by sudden drop in WBCs, respiratory acidosis. History significant for water aspiration from a retention ditch. Recipients: increased WBCs, renal vein thrombosis, and fever. Autopsy on Recipient A revealed disseminated, angioinvasive mold involving lungs, heart, spleen, liver and intestines. Recipient B: transplant nephrectomy was performed, patient was discharged after an 84-day hospitalization, eventually completing 140 total days (∼40 g) of amphotericin B-based therapy without evidence of recurrent infection 6 months after stopping antifungal therapy.
Demonstration of imputability or root cause: 
Using fungi recovered from recipients, a comparative sequence based analysis of the ITS and 28s RNA regions confirmed the identity of these isolates as A. elegans. Both RAPD and ISSR subtyping methods revealed the isolates to be genotypically indistinguishable but distinct from isolates not related to this study.
Imputability grade: 
2 Probable
Suggest references: 
AAA