[Mold infections in lung transplants].

Area of Science:

• Medical Mycology
• Transplant Infectious Diseases
• Pulmonology

Background:

• Invasive mold infections, primarily Aspergillus, complicate over 10% of lung transplant cases.
• These infections exhibit bimodal presentation: early (airway) and late (lung/disseminated).
• Aspergillus colonization and chronic rejection are significant risk factors for invasive disease.

Purpose of the Study:

• To review the epidemiology, risk factors, diagnosis, and management of invasive Aspergillus infections in lung transplant recipients.
• To discuss current prophylaxis strategies and diagnostic markers.
• To outline recommended treatment approaches for invasive aspergillosis.

Main Methods:

• Literature review of invasive mold infections in lung transplantation.
• Analysis of diagnostic criteria, including galactomannan levels.
• Evaluation of prophylaxis and treatment strategies.

Main Results:

• A galactomannan level of 0.5 in bronchoalveolar lavage is a predictive factor for invasive pulmonary infection.
• Targeted prophylaxis and preemptive treatment are increasingly favored over universal prophylaxis.
• Voriconazole monotherapy is the preferred treatment for invasive aspergillosis.

Conclusions:

• Invasive Aspergillus infections pose a significant threat to lung transplant recipients.
• Early detection and risk factor management are crucial.
• Personalized prophylaxis and treatment strategies, including therapeutic drug monitoring, improve outcomes.