Aspergillus Infection After Cardiac Surgery

Gage, Andrew A.; Dean, David C.; Schimert, George; Minsley, Nat

doi:10.1001/archsurg.1970.01340270032009

Cited by 120 publications

(31 citation statements)

References 4 publications

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“…Most prosthetic device infections are due to the introduction of Aspergiltus spores at the time of surgery. In a few instances, infection has been traced to defective ventilation in operating rooms (54,55). Symptoms of infection may not appear for several months to several years after the operative procedure.…”

Section: Major Organ and Disseminated Infectionmentioning

confidence: 99%

Aspergillosis

Bodey

Vartivarian

1989

Eur. J. Clin. Microbiol. Infect. Dis.

303

228

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Aspergillus spores are ubiquitous in the environment and may become concentrated in hospital ventilation systems. Colonization in normal hosts can lead to allergic diseases ranging from asthma to allergic bronchopulmonary aspergillosis. Normal hosts rarely develop invasive disease, which is primarily an infection of severely immunocompromised patients. The major predisposing factors for infection include prolonged neutropenia, chronic administration of adrenal corticosteroids, the insertion of prosthetic devices, and tissue damage due to prior infection or trauma. Since Aspergillus spp. are respiratory pathogens, the most common form of infection is pneumonia followed by sinusitis. Patients with preexistant cavitary disease may develop noninvasive aspergillomas. Most infections are caused by Aspergillus fumigatus. The organism is capable of invading across all natural barriers, including cartilage and bone. It has a propensity for invading blood vessels causing thrombosis and infarction. The diagnosis of pulmonary infection is usually difficult to establish because the organism is seldom cultured from sputum and can represent contamination in some cases. Therapy is immunocompromised hosts is less than satisfactory and amphotericin B is the only agent with significant activity. There is anecdotal evidence to suggest that the addition of 5-fluorocytosine to amphotericin B may be beneficial.

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Section: Major Organ and Disseminated Infectionmentioning

confidence: 99%

Aspergillosis

Bodey

Vartivarian

1989

Eur. J. Clin. Microbiol. Infect. Dis.

303

228

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“…7,8 The contamination of hospital environments by fungal spores was frequently implicated as the cause of aspergillosis in haematological wards or in intensive care units. 9 -12 Reported by Gage et al 13 and Peterham and Seal 14 postoperative Aspergillus spp. infections were related to environmental contamination by A. fumigatus in a surgical ward (SW).…”

Section: Introductionmentioning

confidence: 98%

Environmental investigations and molecular typing of Aspergillus flavus during an outbreak of postoperative infections

Heinemann

Symoens

Gordts

et al. 2004

Journal of Hospital Infection

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“…As suggested by Lecso-Bornet et al [12] and Opal et al [13], who described a case of Aspergillus clavatus aortic valve endocarditis after coronary by-pass surgery, Phialemonium may have been introduced during open heart surgery as a contaminant of the bioprosthesis. Alternatively, airborne conidia may have impacted in the operation field during valve placement [15]. A low growth rate close to the temperature maximum along with other unfavourable factors in the milieu of the body may have retarded the evolution of the infection.…”

Section: Discussionmentioning

confidence: 99%

Late bioprosthetic valve endocarditis caused byPhialemoniumaff.curvatumandStreptococcus sanguis: a case report

Schønheyder

Jensen²,

Gams³

et al. 1996

Med Mycol

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Dual fungal and Streptococcus sanguis endocarditis is reported in a 63-year-old woman 7 months after placement of a porcine aortic valve prosthesis. Both microorganisms were isolated by blood cultures, and the patient succumbed after a full course of antibacterial chemotherapy without having received antifungal chemotherapy. The best possible designation of the fungus was Phialemonium aft. curvatum W. Gams & W. B. Cooke, as represented by CBS 331.93. At autopsy hyphae were revealed in the porcine valve tissue by conventional staining. A hyperimmune rabbit antiserum raised towards strain CBS 331.93 and extensively absorbed with heterologous fungal antigens reacted strongly with hyphae in the valve tissue by indirect immunofluorescence technique. We consider it most likely that the Phialemonium infection evolved insidiously from the time of open heart surgery and led to a haematogenous streptococcal infection of a more fulminant course.

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Aspergillus Infection After Cardiac Surgery

Cited by 120 publications

References 4 publications

Aspergillosis

Aspergillosis

Environmental investigations and molecular typing of Aspergillus flavus during an outbreak of postoperative infections

Late bioprosthetic valve endocarditis caused byPhialemoniumaff.curvatumandStreptococcus sanguis: a case report

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