Native lung pneumonectomy for invasive pulmonary aspergillosis following lung transplantation: a case report.

Abstract

Pulmonary aspergillosis occurs most commonly as a consequence of immunosuppression in recipients of pulmonary transplantation and is associated with a high mortality. It affects the native lung more commonly than the transplanted lung in single lung transplant patients. Infection often progresses despite aggressive medical therapy. The cornerstone of treatment of acute, semi-invasive, and invasive pulmonary aspergillosis (IPA) is medical, with intravenous amphotericin B, and oral itraconazole either as isolated or combined therapy. While newer, and more expensive liposomal forms of amphotericin B have been used to enhance tissue penetration and minimize renal toxicity, an appreciable improvement in clinical outcome has not been reported. The role of surgery in localized pulmonary aspergillus infection is well recognized, but remains undefined in immunosuppressed patients. We report a case where a pneumonectomy was performed for progressive, refractory angioinvasive aspergillosis in a lung transplant recipient whose disease progressed despite conventional antifungal therapy.

• Authors: S Sandur, S M Gordon, A C Mehta, J R Maurer
• Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (J Heart Lung Transplant) Vol. 18 Issue 8 Pg. 810-3 (Aug 1999) ISSN: 1053-2498 [Print] United States
• PMID: 10512532 (Publication Type: Case Reports, Journal Article)

Topics

• Aspergillosis (diagnostic imaging, etiology, surgery)
• Aspergillus fumigatus (isolation & purification)
• Bronchoalveolar Lavage Fluid (microbiology)
• Humans
• Lung (microbiology)
• Lung Diseases, Fungal (diagnostic imaging, etiology, surgery)
• Lung Transplantation (adverse effects)
• Male
• Middle Aged
• Pneumonectomy
• Radiography, Thoracic
• Reoperation
• Tomography, X-Ray Computed