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[Aspergillosis following liver transplantation as a hospital infection]
Abstract:
In the first four weeks after a liver transplantation, there was an invasive aspergillosis with a lethal course in three out of five patients who were treated postoperatively in the same room. The clinical symptoms were very different. One patient was asymptomatic, and the diagnosis could only be made by autopsy. In another patient, pulmonary symptoms, and in the third patient, cerebral symptoms were the most prominent. In the two latter patients, the infection was demonstrated in the sputum and by bronchoalveolar lavage. The disease course was fulminant in all patients, and therapy was without success. Owing to this high incidence, mycological investigations were carried out on the ward. A flower bench in the hall beside the ward was probably the main focus of distribution. To avoid such nosocomial infections, foci of aspergillus distribution should if possible be removed from the surroundings of patients with weakened immune resistance.
Insights
Invasive aspergillosis caused three deaths in five liver transplant patients within four weeks. Environmental decontamination, like removing Aspergillus sources, is crucial for preventing such nosocomial infections.
Area of Science:
- Medicine
- Infectious Diseases
- Transplantation
Background:
- Liver transplantation recipients are highly susceptible to opportunistic infections.
- Invasive aspergillosis poses a significant threat in immunocompromised patients.
Observation:
- A cluster of invasive aspergillosis cases occurred in five liver transplant patients within four weeks post-surgery.
- Three out of five patients experienced a lethal course of invasive aspergillosis.
- Clinical presentations varied, including asymptomatic cases diagnosed post-mortem, pulmonary, and cerebral symptoms.
Findings:
- The infection demonstrated a high incidence and fulminant course, with therapy proving unsuccessful.
- Mycological investigations identified a probable Aspergillus distribution focus in a nearby flower bench.
- Nosocomial transmission was suspected as the source of infection.
Implications:
- Environmental control and removal of Aspergillus distribution foci are critical in preventing nosocomial infections.
- Proactive environmental surveillance and decontamination are essential in transplant units.
- Early diagnosis and aggressive management strategies for invasive aspergillosis in transplant patients need further investigation.