Orbitorhinocerebral mucormycosis following kidney transplantation

Of 688 patients who underwent renal transplantation, three (0.44% developed mucormycosis. The initial symptoms common to all of them were epiphora and periorbital pain. One patient had diabetes mellitus. All developed the serious complication while being treated for renal transplant rejection between the years 1980-85. At this time and until 1987, all cadaveric transplant recipients at our center routinely received azathioprine and high-dose steroids postoperatively; rejection episodes were treated with intravenous methylprednisolone 1000 mg/day for three days. In April 1987 the postoperative immunosuppression protocol was changed to cyclosporine and a tapering dose of prednisone, with rejection episodes treated with methylprednisolone 500 mg/day for three days, followed by anti T-lym-phocyte antibodies (OKT₃, ATG) in resistant cases. It is concluded that the lack of new cases of mucormycosis after 1985 is related to the change in postoperative therapy and acute organ rejection regimen, mainly the reduction in the use of high-dose steroids.