Cutaneous mucormycosis in solid organ transplant recipients after hurricane harvey: Short- and long-term management

Michael Kueht, Joshua A. Villarreal, Edward Reece, N. Thao N. Galvan, Krupa Mysore, Alejandro Restrepo, Norma Quintanilla, Abbas Rana, John Goss

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Summary: In the fall of 2017, Hurricane Harvey, one of the most costly hurricanes in American history, ravaged the Texas Gulf Coast, interrupting basic sanitation systems to hundreds of thousands of Texas residents. In the aftermath of Hurricane Harvey, our Houston hospitals noted an uptick in the incidence of cases of mucormycosis. Among the most vulnerable and affected have been immunocompromised transplant recipients. Here, we describe the successful management of 2 patients with atypical presentations of mucormycosis, 2 cutaneous infections after liver transplantation. Our comprehensive treatment strategy based upon guidelines and experience included coordinating aggressive surgical and medical therapies. We discuss our approach to surgical management including the extent and frequency of debridement, the methods of assessing disease-free margins, and minimizing the morbidity of radical debridement with temporary coverage and forethought to long-term reconstruction. Additionally, we describe the concurrent medical management, including type, route, and duration of antifungal therapy, minimizing suppression of the innate immune system, and optimizing the wound healing environment through maintaining nutritional status.

Original languageEnglish (US)
Article numbere2041
JournalPlastic and Reconstructive Surgery - Global Open
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

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