Pathophysiology
Candida species are the predominant pathogens, followed by Aspergillus species and other moulds like Mucorales. The gastrointestinal tract serves as a major reservoir for Candida, with infections arising from both internal colonization and external sources [PMID:42047169].
Epidemiology
Invasive fungal infections (IFIs) pose a significant threat to patients who undergo intestine transplantation, with incidence rates reported between 40% and 49%—the highest among all solid organ transplant recipients [PMID:42047169].
Clusters of pediatric cases have been reported in endemic regions, with a notable predominance in boys under 10 years old, characterized by abdominal pain and colonic thickening [PMID:41634777].
Clinical Presentation
Intra-abdominal infections typically arise within the first month post-transplant, whereas bloodstream infections tend to occur later, often after six months [PMID:42047169].
Patients often present with nonspecific symptoms such as abdominal pain, anorexia, changes in bowel habits, and palpable mass-like lesions, which can mimic malignancies or other inflammatory conditions [PMID:41634777].
Management
Amphotericin B-liposomal (AmBisome®) is highlighted as a key therapeutic agent due to its enhanced tissue distribution, reduced renal toxicity, and better tolerability compared to conventional amphotericin B formulations [PMID:41634777].
References
1 Alabdely MH, Lum J, Gonzalez BE, Fujiki M, Yetmar ZA. Invasive Fungal Infections After Intestine Transplantation: Epidemiology and Outcomes. Mycoses 2026. link 2 Forooghi M, Hamzavi SS, Yousufzai S, Geramizadeh B, Sharifi S, Nasiri S. Liposomal amphotericin B in the treatment of pediatric gastrointestinal basidiobolomycosis. Journal of medical case reports 2026. link
2 papers cited of 3 indexed.