Invasive Aspergillus Infections Complicating Coronary Artery Bypass Grafting
| Autor: | R. G. Washburn, S. F. Weber |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Male
Sternum medicine.medical_specialty medicine.medical_treatment Aspergillosis Flucytosine Valve replacement Amphotericin B medicine Humans Saphenous Vein cardiovascular diseases Coronary Artery Bypass Aged Chemotherapy Endocarditis business.industry Osteomyelitis Aspergillus infections General Medicine Middle Aged medicine.disease Surgery Cardiac surgery medicine.anatomical_structure Aortic Valve business Artery medicine.drug |
| Zdroj: | Southern Medical Journal. 83:584-588 |
| ISSN: | 0038-4348 |
| DOI: | 10.1097/00007611-199005000-00028 |
| Popis: | Endovascular infection with Aspergillus species results in unacceptably high mortality of greater than 80% in most series. Failure to recognize the infection early during its clinical course contributes to its formidable lethality. Blood cultures almost never reveal organisms, as in our Cases 1 and 2. When considering a patient with fever, changing murmur, major systemic emboli, or splenomegaly, and with blood cultures negative for organisms months or even years after cardiac surgery, therefore, the physician should maintain a high index of suspicion for fungal endocarditis. The best opportunity to establish the diagnosis antemortem rests in careful histopathologic and microbiologic examination of infected emboli and vegetations. Most authors agree that a combined approach employing early valve replacement and aggressive antifungal chemotherapy with amphotericin B and perhaps flucytosine or rifampin represents the best option for treatment of endovascular Aspergillus infections. |
| Databáze: | OpenAIRE |
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