Fungal infections in lung and heart-lung transplant recipients. Report of 9 cases and review of the literature.

Published

Journal Article (Review)

We reviewed the pattern and incidence of fungal infections in patients undergoing lung and heart-lung transplantation at Duke University Medical Center from September 1992 until August 1995, and present here 9 illustrative cases. Of the 73 lung and heart-lung transplant recipients studied, 59 (81%) had positive fungal cultures at some point after transplantation. The cases presented here illustrate that lung transplant recipients are predisposed to a wide variety of fungal infections. The clinical pattern of these infections ranges from asymptomatic to rapidly progressive fatal disease. In addition to the reactivation of previous fungal infections and recent exposure to new environmental sources, the donor lung itself can be the source of fungal infection, as we showed by using molecular epidemiology techniques. Because of the associated morbidity and mortality, efforts should be directed at investigating prophylactic antifungal regimens in lung transplant recipients. Preliminary reports on the use of itraconazole and aerosolized amphotericin B have been encouraging. Prospective randomized studies are needed to assess the safety and cost effectiveness of different regimens. Fungal infections in patients after lung transplantation can significantly impede recovery and lead to substantial mortality.

Full Text

Duke Authors

Cited Authors

  • Kanj, SS; Welty-Wolf, K; Madden, J; Tapson, V; Baz, MA; Davis, RD; Perfect, JR

Published Date

  • May 1996

Published In

Volume / Issue

  • 75 / 3

Start / End Page

  • 142 - 156

PubMed ID

  • 8965683

Pubmed Central ID

  • 8965683

International Standard Serial Number (ISSN)

  • 0025-7974

Digital Object Identifier (DOI)

  • 10.1097/00005792-199605000-00004

Language

  • eng

Conference Location

  • United States