Fungal infections in solid organ transplantation

Marik, Paul E.

doi:10.1517/14656566.7.3.297

Cited by 72 publications

(46 citation statements)

References 78 publications

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“…Systemische Pilzinfektionen gehören zu den klassischen opportunistischen Erkrankungen bei transplantierten Personen, mit hohen Morbiditäts-und Letalitätsraten [23,24,26]. Die Inzidenz von Pilzinfektionen variiert je nach Quelle und transplantiertem Organ deutlich [16]. So liegt die Rate der systemischen Pilzinfektionen nach Lebertransplantationen mit 4-50% am höchsten, während sie für thorakale Transplantationen mit 15-35% und für Nierentransplantationen mit 2-14% angegeben wird [9].…”

Section: Grundlagenunclassified

Caspofungin nach Transplantation solider Organe in Deutschland

et al. 2010

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Section: Grundlagenunclassified

Caspofungin nach Transplantation solider Organe in Deutschland

et al. 2010

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“…to fluconazole for C. albicans . The limited data which are available for prophylactic and empirical treatment strategies of invasive fungal infections in solid organ transplant patients have been reviewed very recently by Marik [57]. …”

Section: Therapy Of Postoperative Bacterial/fungal Infectionsmentioning

confidence: 99%

Postoperative Bacterial/Fungal Infections: A Challenging Problem in Critically Ill Patients after Abdominal Surgery

Lichtenstern

Schmidt²,

Knaebel³

et al. 2007

Dig Surg

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Critically ill patients after extended surgical procedures are at high risk for postoperative infections. The overall incidence of sepsis increased constantly over the last decade, whereas sepsis-related mortality decreased, due to new intensive care options. After extended intra-abdominal surgery the abdomen is the predominant focus of sepsis, followed by respiratory tract infections. Unspecific clinical signs lead to the diagnosis of postoperative sepsis. Early focus identification by clinical, laboratory and radiologic examination is of major importance for a promising therapy, followed by immediately initiated procedures for source control and an adequate anti-infective drug therapy. For nosocomial sepsis, the use of antimicrobial regimens with extended spectra and potent activity against both Gram-negative and Gram-positive bacterial pathogens are warranted. Fungal infections play a great role for immunocompromized patients, e.g. after solid organ transplantation or under chronic corticoid therapy. An increasing incidence of multi-drug resistance in bacterial and fungal isolates has been observed in the last years. This is becoming a growing problem also for critically ill patients after abdominal surgery. Standardized treatment protocols including supportive and adjunctive therapy and the use of modern anti-infective agents may lead to a decrease in postoperative mortality due to sepsis.

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“…The high occurrence of fungal infection could be explained by the immunocompromised status of posttransplant patients and also the angioinvasive nature of fungi. 7,8 Leonardou et al reported two cases with P. aeruginosa isolated from the blood culture, and both patients were treated with ciprofloxacin for 4 weeks in total after surgery. 4 No recurrence was detected up to 36 months.…”

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confidence: 99%

Infectious anastomotic pseudoaneurysm complicating renal allograft: case report and review of literature

Chung¹,

Chan²,

Law³

et al. 2017

IJNRD

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Infectious anastomotic pseudoaneurysm complicating renal transplant is rare, but probably under-reported with <30 cases worldwide. We report a 45-year-old man with hypertension, diabetes mellitus and end stage renal failure, who had a renal transplant anastomosed to the right external iliac artery and vein. Postoperatively, he made a slow recovery with malaise and persistent vague right iliac fossa discomfort. Ultrasound scan 1 month postoperatively showed perinephric collection, and fluid culture grew Enterococcus faecium and Pseudomonas aeruginosa. He was started on vancomycin, daptomycin and colistin. MAG-3 scan also showed suboptimal function in the renal allograft. His symptoms persisted with fever, and blood culture yielded P. aeruginosa. Repeated ultrasound scan, and subsequent computed tomography scan a few weeks later, showed perinephric collection and a large, 3.8×3.5 cm pseudoaneurysm posteromedial to the graft kidney. He underwent emergency graft excision, together with resection of the pseudoaneurysm with in situ reversed great saphenous vein interposition graft, and made a good recovery on hemodialysis. The aneurysm wall grew P. aeruginosa, and he was put on imipenem and cilastatin (tienam), colistin, ciprofloxacin and daptomycin. To our knowledge, this is one of very few cases in the world's literature in which a P. aeruginosa infectious anastomotic pseudoaneurysm developed after a renal allograft.

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Fungal infections in solid organ transplantation

Cited by 72 publications

References 78 publications

Caspofungin nach Transplantation solider Organe in Deutschland

Caspofungin nach Transplantation solider Organe in Deutschland

Postoperative Bacterial/Fungal Infections: A Challenging Problem in Critically Ill Patients after Abdominal Surgery

Infectious anastomotic pseudoaneurysm complicating renal allograft: case report and review of literature

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