Pulmonary zygomycosis in solid organ transplant recipients in the current era
Journal
American Journal of Transplantation
Journal Volume
9
Journal Issue
9
Pages
2166-2171
Date Issued
2009
Author(s)
Aguado J.M.
Bonatti H.
Forrest G.
Gupta K.L.
Safdar N.
John G.T.
Pursell K.J.
Muñoz P.
Patel R.
Fortun J.
Martin-Davila P.
Philippe B.
Philit F.
Tabah A.
Terzi N.
Chatelet V.
Kusne S.
Clark N.
Blumberg E.
Julia M.B.
Humar A.
Houston S.
Lass-Florl C.
Johnson L.
Dubberke E.R.
Barron M.A.
Lortholary O.
Singh N.
Abstract
Fifty-eight solid organ transplant recipients with zygomycosis were studied to assess the presentation, radiographic characteristics, risks for extra-pulmonary dissemination and mortality of pulmonary zygomycosis. Pulmonary zygomycosis was documented in 31 patients (53%) and developed a median of 5.5 months (interquartile range, 2-11 months) posttransplantation. In all, 74.2% (23/31) of the patients had zygomycosis limited to the lungs and 25.8% (8/31) had lung disease as part of disseminated zygomycosis; cutaneous/soft tissue (50%, 4/8) was the most common site of dissemination. Pulmonary disease presented most frequently as consolidation/mass lesions (29.0%), nodules (25.8%) and cavities (22.6%). Patients with disseminated disease were more likely to have Mycocladus corymbifer as the causative pathogen. The mortality rate at 90 days after the treatment was 45.2%. In summary, pulmonary zygomycosis is the most common manifestation in solid organ transplant recipients with zygomycosis, and disseminated disease often involves the cutaneous/soft tissue sites but not the brain. ? 2009 The American Society of Transplantation and the American Society of Transplant Surgeons.
SDGs
Other Subjects
amphotericin B deoxycholate; amphotericin B lipid complex; cyclosporin A; posaconazole; T lymphocyte antibody; tacrolimus; adult; article; brain infection; clinical article; clinical feature; controlled study; female; graft rejection; human; infection risk; lung disease; lung mycosis; male; mortality; mucormycosis; Mycocladus corymbifer; organ transplantation; pathogenesis; priority journal; radiography; risk factor; soft tissue; treatment outcome; Zygomycetes; Adult; Aged; Antifungal Agents; Female; Humans; Lung Diseases, Fungal; Male; Middle Aged; Organ Transplantation; Postoperative Complications; Time Factors; Treatment Outcome; Zygomycosis
Type
journal article