Invasive pulmonary Aspergillosis in organ transplants - Focus on lung transplants

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• 作者：Christian Geltner^a ; ^{christian.geltner@kabeg.at" class="auth_mail" title="E-mail the corresponding author} ; Cornelia Lass-Flö ; rl^b
• 关键词：BAL-GM ; galactomannan test in BAL ; BAL ; bronchoalveolar lavage ; CI ; cumulative incidence ; CMV ; cytomegalovirus ; COPD ; chronic obstructive pulmonary disease ; CT ; computed tomography ; IA ; invasive aspergillosis ; IPM ; invasive pulmonary mycosis ; IRS ; immune reconstitution syndrome ; PTLD ; post transplant lymphoproliferative disease ; SCT ; stem cell transplant ; SOT ; solid organ transplant.
• 刊名：Respiratory Investigation
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：54
• 期：2
• 页码：76-84
• 全文大小：1295 K

文摘

Infections with filamentous fungi are common in transplant recipients. The risk for aspergillosis and other invasive pulmonary mycosis (IPM) is high in patients undergoing stem cell and lung transplantations. The mortality rates range from 20% to 60% and depend on a number of risk factors. The typical manifestations of IPM are lung infiltrates, consolidations, and fungal tracheobronchitis. The most common infectious agent is Aspergillus fumigatus. Infections caused by non-Aspergillus molds are more frequent for various reasons. The species distribution of non-Aspergillus molds varies in different locations. Furthermore, infections caused by Mucor and Penicillium are increasing, as are infections caused by species resistant to azoles and amphotericin B. Most centers use antifungal prophylaxis with inhaled amphotericin B or oral azoles. Early diagnosis and therapy is crucial. Reliable information on the local microbiological spectrum is a prerequisite for the effective treatment of molds with primary or secondary resistance to antimycotic drugs.