Invasive Fungal Infections in Solid Organ Transplant Recipients: A Case Series from a Tertiary University Hospital

In solid organ transplant (SOT) recipients, invasive fungal infections (IFIs) are a significant cause of morbidity and mortality. Thus, the diagnosis, treatment, and management of these infections are of great importance. Eleven different IFIs (five candidemia, three aspergillosis, one cryptococcosis, one intra-abdominal mucormycosis, and one Magnusiomyces infection) were followed up in nine SOT recipients (four kidney, four liver, and one heart transplant), aged 35-66 years. The diagnosis of mucormycosis was based on pathology test results; the other fungi were identified via culture. One patient with candidemia (Candida parapsilosis) developed resistance to fluconazole while under treatment. The study patients had several risk factors for IFIs, including prolonged hospitalization, immunosuppression, broad-spectrum antibiotic use, renal replacement therapy, in-situ central venous catheter, previous antifungal exposure, and reoperation. Focal control was attempted in all patients by withdrawing the catheter if present. Treatments were administered based on antifungal susceptibility results, if available, or in accordance with guideline recommendations. During the follow-up period, six of the nine study patients (66.7%) died. Despite appropriate antifungal treatment and patient management, the mortality rate of IFIs remains high. Therefore, a multidisciplinary approach, including rapid diagnosis, appropriate treatment and focal control, is essential.