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[Aspergillosis in pulmonary transplantation]
A de Pablo1, P Ussetti, M Cruz Carreño
1Servicio de Neumología, Clínica Puerta de Hierro, Madrid.
Enfermedades Infecciosas Y Microbiologia Clinica
|September 7, 2000
Summary
Fungal infections like aspergillosis pose risks to lung transplant recipients. Invasive aspergillosis is often fatal, while tracheobronchitis is treatable with antifungal therapies.
Area of Science:
- Medical Mycology
- Transplant Infectious Diseases
- Pulmonology
Background:
- Fungal infections, particularly Aspergillus spp., are significant causes of illness and death in transplant recipients.
- Aspergillus spp. are common fungi that can cause a range of infections with varying severity.
Purpose of the Study:
- To investigate the incidence and severity of Aspergillus spp. infections following lung transplantation.
- To analyze clinical presentations and responses to antifungal drugs for Aspergillus infections in lung transplant patients.
Main Methods:
- A retrospective review of clinical histories was conducted.
- Patients included underwent lung transplantation and developed positive Aspergillus spp. cultures between June 1991 and December 1996.
Main Results:
- 22% (11 of 49) of lung transplant patients developed Aspergillus spp. infections.
- Invasive aspergillosis occurred in 4 patients, resulting in a 30% mortality rate despite treatment.
- Aspergillar tracheobronchitis occurred in 7 patients, with all cases responding to antifungal treatment.
Conclusions:
- Invasive aspergillosis in the early post-transplant period is frequently fatal, even with treatment.
- Aspergillar tracheobronchitis can be successfully managed with combination antifungal therapies, including liposomal amphotericin, itraconazole, and nebulized amphotericin.