Invasive mold infection of the renal graft

A 59-year-old man, as a liver recipient for 10 years, was referred for further management of open wound at right lower abdomen where kidney graft was implanted recently. The wound, which had been debrided several times, showed gangrenous necrosis of soft tissue with partial exposure of the graft (Figure 1A). The white hairy appearance was seen in contrast to the black eschars (Figure 1B). The graft kidney, in this case, was invaded by molds and en-bloc removal was performed finally, even under aggressive antifungal medications. Pathological examination revealed mucormycosis and aspergillosis, the latter of which had uniform widths of septate hyphae.