J Korean Soc Transplant.  2009 Sep;23(2):172-176. 10.4285/jkstn.2009.23.2.172.

Invasive Gastrointestinal and Cutaneous Mucormycosis in Deceased Donor Small Bowel Transplantation: Case Report and Review of Literature

  • 1Department of Surgery, Samsung Medical Center, Sungkyunwan University School of Medicine, Seoul, Korea. sukkoo.lee@samsung.com


Fungal infection is an uncommon complication after small bowel transplantation. We present a rare form of mucormycosis found in the small bowel graft and in the skin of a recipient. We reviewed chart data and performed MEDLINE searches and found that this case was the first to report 2 kinds of mucormycosis to be found after organ transplantation. The patient was a 12 month old female baby who underwent small bowel transplantation due to short bowel syndrome. After 12 days she experienced acute cellular rejection which responded to steroid. 6 days later due to sustained fever, poor feeding and abdominal distention endoscopic biopsy was done which revealed mucormycosis. Antifungal treatment with lipo-amphotericin B was initiated, yet there was no improvement of clinical symptoms. On the 23 post operative day a black eschar developed on the incision site of the skin and biopsy was done which revealed cutaneous mucormycosis. Infected skin debridement and graftectomy was done but our patient expired because of septic shock.


Small bowel transplantation; Mucormycosis; Fungal infection

MeSH Terms

Organ Transplantation
Rejection (Psychology)
Shock, Septic
Short Bowel Syndrome
Tissue Donors


  • Fig. 1. the finding of endoscopic biopsy of ileum at postoperative 12 days showed severe acute cellular rejection with diffuse crypt epithelial injury, focal confluent apoptosis, and shallow ulcer (×100).

  • Fig. 2. At postoperative 18 days, the finding of endoscopic biopsy through ileostomy showed necrotizing material with fungal hyphae and was consistent mucormycosis. (A) PAS stain (×400), (B) Grocott’Methenamine stain (×200).

  • Fig. 3. (A) Black pigmented necrotic tissue in operative wound and ileostomy, (B) Multiple hyphae were showed in biopsy of black pigmented necrotic skin (black arrow, ×400).

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