Monster Lung Cavity in a Heart Transplant Recipient

Authors

  • Brandon T. Nokes Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona
  • Octavio Pajaro Department of Cardiovascular and Thoracic Surgery, Mayo Clinic, Scottsdale, Arizona
  • Jenise Stephen Pharmacy, Mayo Clinic, Scottsdale, Arizona
  • Patrick DeValeria Department of Cardiovascular and Thoracic Surgery, Mayo Clinic, Scottsdale, Arizona
  • Robert Scott Cardiovascular Diseases, Mayo Clinic Hospital, Phoenix, Arizona
  • Sadia Shah Pulmonary Medicine and Critical Care Medicine, Mayo Clinic Hospital, Phoenix, Arizona
  • Eric Steidley Cardiovascular Diseases, Mayo Clinic Hospital, Phoenix, Arizona
  • Jama Jahanyar Department of Cardiovascular and Thoracic Surgery, Mayo Clinic, Scottsdale, Arizona

DOI:

https://doi.org/10.1532/hsf.1922

Keywords:

antifungal therapy, heart transplantation, immunosuppression, mucormycosis

Abstract

Invasive mucormycosis infections occur in less than 1% of recipients of orthotopic heart transplants. Given the angioinvasive nature of these infections, the mortality rate is high. Little literature exists regarding the presentation and management of these infections. We present a case of a patient who developed an infection after orthotopic heart transplant, describe the successful multidisciplinary management surrounding his care, and review the available literature regarding mucormycosis infections in heart transplant recipients.

References

Abidi MZ, Sohail MR, Cummins N, et al. 2014. Stability in the cumulative incidence, severity and mortality of 101 cases of invasive mucormycosis in high-risk patients from 1995 to 2011: a comparison of eras immediately before and after the availability of voriconazole and echinocandin-amphotericin combination therapies. Mycoses 57:687-698.

Bhagat M, Rapose A. 2016. Rapidly progressing dual infection with Aspergillus and Rhizopus: when soil inhabitants become deadly invaders. BMJ Case Rep Dec 8;2016.

Grossi P, Farina C, Fiocchi R, Dalla Gasperina D. 2000. Prevalence and outcome of invasive fungal infections in 1,963 thoracic organ transplant recipients: a multicenter retrospective study. Italian Study Group of Fungal Infections in Thoracic Organ Transplant Recipients. Transplantation 70:112-116.

Ko WJ, Chien NC, Chou NK, et al. 2000. Infection in heart transplant recipients: seven years’ experience at the National Taiwan University Hospital. Transplant Proc 32:2392-2395.

Petrikkos G, Skiada A, Lortholary O, et al. 2012. Epidemiology and clinical manifestations of mucormycosis. Clin Infect Dis 54 Suppl1:S23-34.

Schowengerdt KO, Naftel DC, Seib PM, et al. 1997. Infection after pediatric heart transplantation: results of a multiinstitutional study. The Pediatric Heart Transplant Study Group. J Heart Lung Transplant 16:1207-1216.

Spellberg B, Edwards J, Jr., Ibrahim A. 2005. Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clin Microbiol Rev 18:556-569.

Spellberg B, Walsh TJ, Kontoyiannis DP, Edwards J, Jr., Ibrahim AS. 2009. Recent advances in the management of mucormycosis: from bench to bedside. Clin Infect Dis 48:1743-1751.

Tan HP, Razzouk A, Gundry SR, Bailey L. 1999. Pulmonary Rhizopus rhizopodiformis cavitary abscess in a cardiac allograft recipient. J Cardiovasc Surg (Torino) 40:223-226.

Webb BJ, Blair JE, Kusne S, et al. 2013. Concurrent pulmonary Aspergillus fumigatus and mucor infection in a cardiac transplant recipient: a case report. Transplant Proc 45:792-797.

Williams KE, Parish JM, Lyng PJ, et al. 2014. Pseudomembranous tracheobronchitis caused by Rhizopus sp. After allogeneic stem cell transplantation. J Bronchology Interv Pulmonol 21:166-169.

Published

2018-03-05

How to Cite

Nokes, B. T., Pajaro, O., Stephen, J., DeValeria, P., Scott, R., Shah, S., Steidley, E., & Jahanyar, J. (2018). Monster Lung Cavity in a Heart Transplant Recipient. The Heart Surgery Forum, 21(2), E072-E074. https://doi.org/10.1532/hsf.1922

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