Mucormycosis and Cytomegalovirus Co-infection in Renal Transplant Recipients

245 Opportunistic infections have a high incidence among hematopoetic and solid organ transplant recipients with compromised cell‐mediated immunity induced by immunosuppression.[1] Cytomegalovirus (CMV) infection is frequently seen in the renal transplant recipients, especially those who have received T‐cell depleting antibodies.[2] CMV infection produces immuno‐modulatory effects, resulting in further immunosuppression that predisposes transplant recipients to develop serious non‐CMV infections, like invasive fungal infections, following transplantation.[2] Mucormycosis is a rare and life‐threatening invasive fungal infection caused by fungi of the Zygomycetes class and order Mucorales.[3] Rhizopus, Mucor, and Rhizomucor are the genera most frequently identified in the posttransplant setting.[4,5] Based on the route of infection and symptomatology, mucormycosis may present with different clinical syndromes with the rhino‐cerebral and pulmonary being more common. Gastrointestinal (GI) mucormycosis is rare, accounting for only 7%, and has a high mortality rate of 85%.[6] GI mucormycosis may occur in any part of the alimentary tract, with the stomach being most commonly involved. In a recent issue of this journal, Nandwani et al. have described an interesting case of CMV and Mucor co‐infection of the GI tract within 4 weeks of an ABO‐incompatible (ABOi) renal transplantation.