Invasive Aspergillosis in Solid Organ Transplant Recipients

Singh, Nina; Husain, Shahid

doi:10.1111/j.1600-6143.2009.02910.x

Cited by 113 publications

(98 citation statements)

References 120 publications

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“…With the exception of Candida species, organisms causing fusariosis, Cryptococcus species, and Histoplasma species, it is difficult to isolate these organisms from blood cultures; the isolation of organisms from urine (Candida) or respiratory cultures (Candida and sometimes Aspergillus) may reflect colonization rather than infection in certain circumstances (81,94). Further complicating diagnostic confirmation is the slow growth of some fungi in cultures, a factor that may substantially delay the diagnosis.…”

Section: Other Fungal Infectionsmentioning

confidence: 99%

Common Infections in Kidney Transplant Recipients

Karuthu¹,

Blumberg

2012

Clinical Journal of the American Society of Nephrology

214

148

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SummaryInfections are a major cause of morbidity and mortality in kidney transplant recipients. To some extent, these may be preventable. Careful pretransplant screening, immunization, and post-transplant prophylactic antimicrobials may all reduce the risk for post-transplant infection. However, because transplant recipients may not manifest typical signs and symptoms of infection, diagnoses may be confounded. Furthermore, treatment regimens may be complicated by drug interactions and the need to maintain immunosuppression to avoid allograft rejection. This article reviews common post-transplant infections, including prophylactic, diagnostic, and treatment strategies, providing guidance regarding care of kidney transplant patients with infection.

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Section: Other Fungal Infectionsmentioning

confidence: 99%

Common Infections in Kidney Transplant Recipients

Karuthu¹,

Blumberg

2012

Clinical Journal of the American Society of Nephrology

214

148

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“…Durante el segundo período (31 a 180 días) el efecto neto de la inmunosupresión tiene su máxima expresión por lo que predominan las infecciones por Aspergillus spp., seguido por otros hongos filamentosos, reactivaciones de micosis endémicas o criptococosis. En el tercer período, cumplidos los seis meses, las infecciones fúngicas son infrecuentes y suelen asociarse a períodos de inmunosupresión en el contexto de elevación de dosis de inmunosupresores por rechazo o infecciones por citomegalovirus (CMV) 26 . Sin embargo, de acuerdo a datos recientes, se describe un desplazamiento de las EFI en TOS, con medianas de tiempo para manifestación de candidiasis, aspergilosis y criptococosis de 103, 184 y 575 días, respectivamente 17 .…”

Section: Trasplantes De óRganos Sólidosunclassified

Profilaxis antifúngica en niños y adultos sometidos a trasplante de órganos sólidos y de precursores hematopoyéticos

Rabagliati¹,

Santolaya²

2012

Rev. chil. infectol.

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Prophylaxis against fungal infections in solid organ and hematopoietic stem cells transplantationInvasive fungal infections are an important cause of morbidity and mortality in SOT and HSCT recipients. The main species involved are Candida spp. and Aspergillus spp, less frequently Cryptococcus spp., causal agents of mucormycosis and Fusarium spp. Usually occur within the first six months post-transplant, but they do it later, especially during episodes of rejection, which maintains the state of immune system involvement. Prophylaxis recommendations are specific to each type of transplant. In liver transplantation use of fluconazole is recommended only in selected cases by high risk factor for invasive fungal infections (A1). If the patient has a high risk of aspergillosis, there are some suggestions for adults population to use amphotericin B-deoxycholate, liposomal amphotericin B or caspofungin (C2) without being validated none of these recommendations in pediatric population. In adult lung transplant patients where the risk of aspergillosis is higher than in other locations, we recommend universal prophylaxis with itraconazole 200 mg/day, nebulised liposomal amphotericin B or voriconazole (C2), no validated recommendations for pediatrics. In HSCT, universal prophylaxis is recommended only in allogeneic and autologous selected cases. The most accepted indication is fluconazole (A1), and posaconazole (A1) or micafungin (A1) in selected cases with high risk of aspergillosis.Key words: Fungus, Candida, Aspergillus, yeasts, moulds, prophylaxis, amphotericin, fl uconazole, voriconaamphotericin, fluconazole, voriconazole, posaconazole, caspofungin, micafungin, transplants, solid organ transplantation, hematopoietic stem cells transplantation.Palabras clave: Hongos, Candida, Aspergillus, levaduras, hongos filamentosos, profilaxis, anfotericina, fluconazol, voriconazol, posaconazol, caspofungina, micafungina, trasplante, trasplante de órganos sólidos, trasplante de precursores hematopoyéticos. IntroducciónL as infecciones fúngicas constituyen una importante causa de morbilidad en los pacientes receptores de trasplantes de órganos sólidos (TOS) y trasplante de precursores hematopoyéticos (TPH) 1 , generando desafíos diagnósticos y terapéuticos, elevación de los costos de manejo y elevada mortalidad 2,3 . En los receptores de trasplantes, la enfermedad fúngica invasora (EFI) es provocada tanto por hongos levaduriformes como filamentosos, destacando Candida spp. y Aspergillus spp. 2-4 , menos frecuentemente Cryptococcus spp., agentes causales de mucormicosis 5,6 y Fusarium spp. 7 , infecciones por hongos endémicos como Histoplasma capsulatum, Coccidioides immitis, Paracoccidioides brasiliensis, y con menor cuantía dematiáceos como Cladosporium, Cladophialophora, Scopulariopsis, Alternaria, Curvularia y Bipolaris spp 8 .Existen diferencias en la frecuencia de EFI entre los distintos tipos de TOS y TPH; no obstante, algunas características son comunes: en ambos grupos la mayoría de las EFI son producidas por Candida spp. o ...

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“…Endemic fungal infections are associated with pathogens like Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides immitis. For detailed review of the various types of fungal infections in solid organ transplantation, the reader is referred to references [42,45,46,[48][49][50][51]. Although rare, donor-derived fungal infections are important to consider; recent guidelines outline occurrence and management of such infections [48].…”

Section: Fungal Infectionmentioning

confidence: 99%