Factors associated with invasive lung aspergillosis and the significance of positive Aspergillus culture after liver transplantation.

Published

Journal Article

From January 1981 to December 1990, 2180 patients underwent orthotopic liver transplantation at the University of Pittsburgh. Thirty-two patients (1.5%) were identified with invasive aspergillosis (29 lung, 2 intraabdominal, 1 meningitis). Of 29 patients with invasive lung disease, only 23 (79%) had positive culture (Aspergillus fumigatus, 20; Aspergillus flavus, 3). Forty-eight variables were analyzed and compared in 23 patients with invasive disease with positive cultures and 9 patients with colonization only. The variables associated with pulmonary invasive disease, by univariate analysis, were surgical time (P = .03), presence of laparotomies (P = .02), higher creatinine level at time of Aspergillus isolation (P = .01), and use of OKT3 (P = .02). However, in a multivariate analysis, only the last two (creatinine, OKT3) were associated with invasive lung aspergillosis. Of 4 patients with positive abdominal wound culture, 2 had local invasive aspergillosis. Therefore, positive cultures of Aspergillus organisms from respiratory secretions and wound drainage may represent invasive disease and should not be ignored.

Full Text

Duke Authors

Cited Authors

  • Kusne, S; Torre-Cisneros, J; Mañez, R; Irish, W; Martin, M; Fung, J; Simmons, RL; Starzl, TE

Published Date

  • December 1992

Published In

Volume / Issue

  • 166 / 6

Start / End Page

  • 1379 - 1383

PubMed ID

  • 1431256

Pubmed Central ID

  • 1431256

Electronic International Standard Serial Number (EISSN)

  • 1537-6613

International Standard Serial Number (ISSN)

  • 0022-1899

Digital Object Identifier (DOI)

  • 10.1093/infdis/166.6.1379

Language

  • eng