Fungal Infection in Lung Transplantation

Kennedy, Cassie C.; Pennington, Kelly; Beam, Elena; Razonable, Raymund R.

doi:10.1055/s-0041-1729173

Cited by 10 publications

(16 citation statements)

References 79 publications

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“…often cause nosocomial infections in LTR. Candida infections commonly occur within the first 3 months post transplantation due to the presence of indwelling catheters, anastomotic dehiscence, and post-surgical complications [ 1 ]. The incidence of invasive candidiasis (IC) from 1980–2004 was 5.2%, and the most commonly isolated species were Candida albicans , Candida glabrata , and Candida parapsilosis [ 84 ].…”

Section: Candidamentioning

confidence: 99%

“…Histoplasmosis is endemic to the Midwestern United States, Mexico, and certain regions of South America and is thought to occur in less than 0.5% of SOT recipients in these endemic areas [ 1 ]. Symptoms of infection in SOT patients are typically non-specific and may be disproportionate to disease severity, but usually involve fever with imaging evidence of extra-pulmonary infection; infections indicative of progression include hepatosplenomegaly, pneumonia, GI disturbances, pancytopenia, weight loss, transaminase elevations, and lactate dehydrogenase elevations [ 42 ].…”

Section: Histoplasmosismentioning

confidence: 99%

“…Fungal infections are common in lung transplant recipients (LTR). The cumulative 1-year incidence of fungal infections in LTR ranges from 10–22% [ 1 ]. In a population-based cohort study of about 9200 solid organ transplant (SOT) recipients, LTR had the highest incidence of invasive fungal infections (IFI) at 43 per 1000 person-years and a 10-year probability of 26.4% [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnosis and Treatment of Fungal Infections in Lung Transplant Recipients

2023

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Fungal infections are a significant source of morbidity in the lung transplant population via direct allograft damage and predisposing patients to the development of chronic lung allograft dysfunction. Prompt diagnosis and treatment are imperative to limit allograft damage. This review article discusses incidence, risk factors, and symptoms with a specific focus on diagnostic and treatment strategies in the lung transplant population for fungal infections caused by Aspergillus, Candida, Coccidioides, Histoplasma, Blastomyces, Scedosporium/Lomentospora, Fusarium, and Pneumocystis jirovecii. Evidence for the use of newer triazole and inhaled antifungals to treat isolated pulmonary fungal infections in lung transplant recipients is also discussed.

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Section: Candidamentioning

confidence: 99%

Section: Histoplasmosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnosis and Treatment of Fungal Infections in Lung Transplant Recipients

2023

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“…3 ). The treatment of fungal infections after LT is based on the specific fungal pathogen being targeted [ 48 ].…”

Section: Pulmonary Complicationsmentioning

confidence: 99%

Medical Complications of Lung Transplantation

Park

2022

J Chest Surg

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Lung transplantation (LT) is now considered as an effective treatment option for end-stage lung diseases that improves the short and long-term survival rates and quality of life. As increasingly many LT procedures are being performed, the medical complications of LT are also increasing in frequency and emerging as a very important issue for transplant clinicians. Although chronic lung allograft dysfunction and infection are major causes of death after LT, many medical complications, several of which result from immunosuppressive treatment, contribute to increased mortality and morbidity. This article reviews the most frequent and important medical complications of LT, accompanied by a review of the literature and studies from South Korea, including lung allograft rejection, infection, and non-allograft organ systemic complications.

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“…According to The International Society for Heart and Lung Transplantation, an IFD in lung transplant recipients is defined as the presence of fungus in respiratory secretions in the setting of symptoms, radiographic changes, and endobronchial changes or histological changes consistent with fungal invasion of the tissue 1. It is estimated that roughly 10-12% of pediatric lung transplant recipients develop a pulmonary IFD within 1 year of transplant [2][3][4]. Pulmonary IFDs have serious implications following lung transplantation.…”

mentioning

confidence: 99%

Identification of Irpex and Rhodotorula on surveillance bronchoscopy in a pediatric lung transplant recipient: A case report and review of literature of these atypical fungal organisms

Atwood,

Köhler,

Vargas

et al. 2024

Pediatric Transplantation

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BackgroundInvasive fungal disease (IFD) is a frequent complication in pediatric lung transplant recipients, occurring in up to 12% of patients in the first year. Risk factors for infection include impaired lung defenses and intense immunosuppressive regimens. While most IFD occurs from Aspergillus, other fungal conidia are continuously inhaled, and infections with fungi on a spectrum of human pathogenicity can occur.Case ReportWe report a case of a 17‐year‐old lung transplant recipient in whom Irpex lacteus and Rhodotorula species were identified during surveillance bronchoscopy. She was asymptomatic and deemed to be colonized by Irpex lacteus and Rhodotorula species following transplant. 2 years after transplantation, she developed a fever, respiratory symptoms, abnormal lung imaging, and histological evidence of acute and chronic bronchitis on transbronchial biopsy. After developing symptoms concerning for a pulmonary infection and graft dysfunction, she was treated for a presumed IFD. Unfortunately, further diagnostic testing could not be performed at this time given her tenuous clinical status. Despite the initiation of antifungal therapy, her graft function continued to decline resulting in a second lung transplantation.ConclusionsThis case raises the concern for IFD in lung transplant recipients from Irpex species. Further investigation is needed to understand the pathogenicity of this organism, reduce the incidence and mortality of IFD in lung transplant recipients, and refine the approach to diagnosis and manage the colonization and isolation of rare, atypical fungal pathogens in immunocompromised hosts.

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Fungal Infection in Lung Transplantation

Cited by 10 publications

References 79 publications

Diagnosis and Treatment of Fungal Infections in Lung Transplant Recipients

Diagnosis and Treatment of Fungal Infections in Lung Transplant Recipients

Medical Complications of Lung Transplantation

Identification of Irpex and Rhodotorula on surveillance bronchoscopy in a pediatric lung transplant recipient: A case report and review of literature of these atypical fungal organisms

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