Long-Term Pulmonary Infections in Heart Transplant Recipients
| Autor: | Öner Eyüboğlu F, Elif Kupeli, Gaye Ulubay, Atilla Sezgin, Esma Sevil Akkurt |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Myocarditis Turkey medicine.medical_treatment Opportunistic Infections Immunocompromised Host Young Adult Predictive Value of Tests Risk Factors Internal medicine Bronchoscopy medicine Humans Antibiotic prophylaxis Lung Respiratory Tract Infections Retrospective Studies Invasive Pulmonary Aspergillosis Heart transplantation Transplantation business.industry Immunosuppression Dilated cardiomyopathy Antibiotic Prophylaxis Middle Aged medicine.disease Anti-Bacterial Agents Surgery Early Diagnosis Treatment Outcome medicine.anatomical_structure Heart Transplantation Sputum Female medicine.symptom Tomography X-Ray Computed business Immunosuppressive Agents |
| Zdroj: | Experimental and Clinical Transplantation. 13:356-360 |
| ISSN: | 2146-8427 1304-0855 |
| DOI: | 10.6002/ect.mesot2014.p205 |
| Popis: | Objectives Pulmonary infections are life-threatening complications in heart transplant recipients. Our aim was to evaluate long-term pulmonary infections and the effect of prophylactic antimicrobial strategies on time of occurrence of pulmonary infections in heart transplant recipients. Materials and methods Patients who underwent heart transplantation between 2003 and 2013 at Baskent University were reviewed. Demographic information and data about immunosuppression and infectious episodes were collected. Results In 82 heart transplant recipients (mean age, 33.85 y; 58 male and 24 female), 13 recipients (15.8%) developed pulmonary infections (mean age, 44.3 y; 9 male and 4 female). There were 12 patients who had dilated cardiomyopathy and 1 patient who had myocarditis before heart transplantation; 12 patients received immunosuppressive therapy in single or combination form. Pulmonary infections developed in the first month (1 patient), from first to third month (6 patients), from third to sixth month (1 patient), and > 6 months after transplantation (5 patients). Chest computed tomography showed consolidation (unilateral, 9 patients; bilateral, 4 patients). Multiple nodular consolidations were observed in 2 patients and a cavitary lesion was detected in 1 patient. Bronchoscopy was performed in 6 patients; 3 patients had Aspergillus fumigatus growth in bronchoalveolar lavage fluid, and 2 patients had Acinetobacter baumannii growth in sputum. Treatment was empiric antibiotics (6 patients), antifungal drugs (5 patients), and both antibiotics and antifungal drugs (2 patients); treatment period was 1-12 months in patients with invasive pulmonary aspergillosis. Conclusions Pulmonary infections are the most common cause of mortality in heart transplant recipients. A. fumigatus is the most common opportunistic pathogen. Heart transplant recipients with fever and cough should be evaluated for pulmonary infections, and invasive pulmonary aspergillosis should be suspected if these symptoms occur within the first 3 months. Immediately starting an empiric antibiotic is important in treating pulmonary infections in heart transplant recipients. |
| Databáze: | OpenAIRE |
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