Delayed sternotomy wound infection due to Paecilomyces variotii in a lung transplant recipient.
We report a case of sternotomy wound infection caused by Paecilomyces variotii in a previously bronchiectatic patient, occurring 10 months after bilateral sequential lung transplantation. The use of prophylactic antifungal therapy, the persistent colonization with Paecilomyces, and sternal instability after clamshell incision may have contributed to the development of delayed deep sternal wound infection. Besides antifungal therapy, vigorous surgical debridement is vital for treatment success. With the more liberal use of early post-transplant fungal prophylaxis, potentially drug-resistant fungi, such as the Paecilomyces species, may be emerging as important opportunistic pathogens after lung transplantation.
Lee
Joseph
J
Tuberculosis and Chest Unit, Grantham Hospital, Aberdeen, Hong Kong, China. josephlee59@yahoo.com
Yew
Wing Wai
WW
Chiu
Clement Shui Wah
CS
Wong
Poon Chuen
PC
Wong
Chi Fong
CF
Wang
Elaine P
EP
D000328:Adult; D003646:Debridement; D005260:Female; D006801:Humans; D016040:Lung Transplantation; D009181:Mycoses; D010143:Paecilomyces; D013249:Sternum / Q000601:surgery; D013530:Surgical Wound Infection / Q000382:microbiology*; D013997:Time Factors