Treatment of Disseminated Mucormycosis in Solid Organ Transplantation

Clinical Scenario

This protocol applies to patients with disseminated mucormycosis who have a history of solid organ transplantation (SOT). The transplant context shapes both the urgency of intervention and the specific management strategy used.

Treatment Approach

Management combines early surgical intervention with immediate systemic antifungal therapy initiated from day one.

The full protocol specifies the preferred agents, the dosing strategy, and the criteria for transitioning to oral consolidation — see the complete regimen via the link below.

Treatment Goals

The target is stable disease or partial response, defined by resolution of signs and symptoms of infection and substantial radiographical improvement. Response is monitored by regular imaging throughout the course of treatment.

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References

If SOT
The guideline group strongly supports an early complete surgical treatment for mucormycosis whenever possible, in addition to systemic antifungal treatment.
In kidney transplant recipients, amphotericin B lipid complex 10 mg/kg per day has been given.
Doses should not be slowly increased over several days; rather, the full daily dose should be given from the first treatment day.
When switching to oral treatment, use of isavuconazole or posaconazole delayed release tablets is strongly supported.
In view of the rapid progress of mucormycosis, weekly CT scans are strongly recommended, particularly in unstable patients.
therapy can be continued until resolution of signs and symptoms of infection, and substantial radiographical improvement.

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