Atypical Presentation of Aspergillus Mediastinitis Infection in a Heart Transplant Patient: the Importance of Combined Medical and Surgical Treatment
| Autor: | Michelle Dubois, Michel Tessier, Mario Sénéchal, Phillipe Gervais, Julien Caron, Alexandre Cinq-Mars, Sacha-Michelle Dubois-Sénéchal, Rinaldi Pietro, Massimo Conti |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Antifungal Agents Rapidly progressive course Aspergillosis Aspergillus fumigatus Postoperative Complications medicine Humans Surgical treatment Transplantation Aspergillus biology business.industry Middle Aged medicine.disease biology.organism_classification Mediastinitis Combined Modality Therapy Surgery Drainage Heart Transplantation Transplant patient Presentation (obstetrics) business |
| Zdroj: | Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation. 17(5) |
| ISSN: | 2146-8427 |
| Popis: | Aspergillus fumigatus is an opportunistic fungus that mainly affects immunocompromised patients. Due to significant immunosuppressive therapy, patients who undergo orthotopic heart transplant have an increased risk of infection. Aspergillosis is the most common fungal infection in orthotopic heart transplant recipients (70%) and usually presents as invasive aspergillosis, which has a rapidly progressive course and is highly fatal. In heart transplant patients with invasive aspergillosis, overall mortality may range from 53% to 78%. Aspergillus mediastinitis infection is somewhat rare in orthotopic heart transplant recipients, with only 6 reported cases. Treatment may require early surgical drainage and antifungal therapy. We present the case of a 50-year-old man who developed Aspergillus mediastinitis 1 year after heart transplant surgery. This case illustrates the diagnostic challenge of an atypical presentation of Aspergillus mediastinitis and the importance of multiple drainage procedures in refractory disease, combined with long-term antifungal therapy. |
| Databáze: | OpenAIRE |
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