Abstract
Fungal infection after solid organ transplantation poses a diagnostic and therapeutic challenge. We present the case of a 50-year-old man who underwent orthotopic heart transplantation for dilated cardiomyopathy with a history of treated pulmonary tuberculosis 10 years pre-transplant. One year post-transplantation, he was admitted with recurrent productive cough and was evaluated to have intracavitory aspergillosis of the lung. He was started on medical therapy with reduction in immunosuppression, but succumbed later with allograft rejection and multiorgan failure. Management of invasive aspergillosis in immunocompromised host is a real challenge. Management protocol should be individualised.
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References
Singh N, Paterson D L. Aspergillus infections in transplant recipients. Clinlin Microbiol Rev. 2005;18:44–69.
Grossi P, Farina C, Fiocchi R, Gasperina D. Prevalence and outcome of invasive fungal infections in 1,963 thoracic organ transplant recipients. Transplantation. 2000;70:112–116.
Montoya JG, Chaparro SV, Celis D, et al. Invasive aspergillosis in the setting of cardiac transplantation. Clin Infect Dis. 2003;37:S281–S292.
Paterson DL, Singh N. Invasive aspergillosis in transplant recipients. Medicine. 1999;78:123–138.
Centeno-Lima S, de Lacerda JM, do Carmo JA, Abecasis M, Casimiro C, Exposto F. Follow-up of anti-Aspergillus IgG and IgA antibodies in bone marrow transplanted patients with invasive aspergillosis. J Clin Lab Anal. 2002;16:156–162.
Herbrecht R, Denning DW, Patterson TF, et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med. 2002;347:408–415.
Walsh TJ, Anaissie EJ, Denning DW. Treatment of aspergillosis: clinical practice guidelines of the infectious diseases society of America. Clin Infect Dis. 2008;46:327–360.
Habicht JM, Reichenberger F, Gratwohl A, Zerkowski HR, Tamm M. Surgical aspects of resection for suspected invasive pulmonary fungal infection in neutropenic patients. Ann Thorac Surg. 1999;68:321–325.
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Nair, V.V., Narayan, K.V., Pulikottil, S.K. et al. Should all tubercular cavities be left alone? Lessons from a heart transplant. Indian J Thorac Cardiovasc Surg 35, 64–67 (2019). https://doi.org/10.1007/s12055-018-0714-3
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DOI: https://doi.org/10.1007/s12055-018-0714-3