Renal allograft arterial mucormycosis presenting with recurrent vascular blowout

Infections, both traditional and opportunistic, constitute a major cause of morbidity and mortality in kidney transplant recipients. Mucorales, ubiquitous environmental fungi, is the cause for a rare but devastating opportunistic infection. Here, we describe a patient with an unusual mucor infection involving the graft kidney and the graft renal artery who, following a deceased donor kidney transplantation, presented in the early posttransplantation period with a vascular blowout and massive hemorrhage. Prompt aggressive resuscitation and surgical intervention saved his life; however, the renal allograft could not be preserved. The key to success in such a life-threatening atypical presentation includes a high index of suspicion, early recognition, and prompt therapeutic intervention.