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[Fungal infections in 100 patients subjected to heart transplantation]
D E Uip1, V Amato Neto, T M Varejão Strabelli
1Divisão de Moléstias Infecciosas e Parasitárias e Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo.
Purpose:
To evaluate prevalence, causes, clinical aspects, topography and deaths due to fungal infections diagnosed in a series of patients submitted to heart transplantation.
Methods:
100 consecutive patients submitted to heart transplantation were studied. Follow-up was three to 90 (mean 25.38 +/- 25.97) months. Fungal infections were diagnosed by the Centers for Disease Control criteria.
Results:
Forty seven fungal infections were found, with three deaths caused mainly by fungal infection. The most common infection in this series was oral infection by Candida albicans, Acremonium sp, Aspergillus sp, Candida tropicalis, Histoplasma capsulatum and Pneumocystis carinii were also responsible for infections in this patient population.
Conclusion:
Fungal infections caused three deaths in this series, and were responsible for increased morbidity. The authors suggest prophylactic and therapeutic recommendations.
Insights
Fungal infections are a significant concern following heart transplantation, causing increased illness and three deaths in a recent study. Early diagnosis and treatment are crucial for managing these infections in transplant recipients.
Area of Science:
- Medical Mycology
- Transplant Infectious Diseases
Background:
- Fungal infections pose a serious threat to immunocompromised patients, particularly those undergoing organ transplantation.
- Understanding the epidemiology and clinical impact of fungal infections in heart transplant recipients is critical for patient outcomes.
Purpose of the Study:
- To determine the prevalence, causes, clinical presentation, and mortality associated with fungal infections in heart transplant patients.
- To analyze the specific fungal species and their impact on morbidity and mortality in this population.
Main Methods:
- A prospective study of 100 consecutive heart transplant patients.
- Diagnosis of fungal infections based on Centers for Disease Control criteria.
- Follow-up duration ranged from 3 to 90 months (mean 25.38 months).
Main Results:
- Forty-seven fungal infections were identified in the study cohort.
- Candida albicans was the most frequent cause, leading to oral infections.
- Other identified fungi included Acremonium sp., Aspergillus sp., Candida tropicalis, Histoplasma capsulatum, and Pneumocystis carinii.
- Three deaths were directly attributed to fungal infections, highlighting their severity.
Conclusions:
- Fungal infections contribute significantly to morbidity and mortality after heart transplantation.
- Prophylactic and therapeutic strategies are recommended to mitigate the risks associated with these infections.
- Further research into targeted antifungal interventions is warranted for heart transplant recipients.