A case of Aspergillus mediastinitis after heart transplantation successfully treated with liposomal amphotericin B, caspofungin and voriconazole.
Reported here is a case of mediastinitis caused by Aspergillus fumigatus and Staphylococcus epidermidis following a heart transplantation that was successfully treated with amphotericin B in combination with new antifungal drugs (caspofungin and voriconazole), antibiotics and superficial wound drainage. A review of the literature revealed that Aspergillus as a cause of mediastinitis has been rarely described. In the few existing reports, evolution was generally fatal, especially in immunocompromised patients, despite treatment with antifungal drugs and surgery.
Forestier
E
E
Infectious Diseases Department, Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, 67094 Strasbourg Cedex, France. emmanuel.forestier@medecine.u-strasbg.fr
Remy
V
V
Lesens
O
O
Martinot
M
M
Hansman
Y
Y
Eisenmann
B
B
Christmann
D
D
D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy*; D001232:Aspergillus fumigatus; D000077336:Caspofungin; D054714:Echinocandins; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D055666:Lipopeptides; D008480:Mediastinitis / Q000188:drug therapy / Q000382:microbiology*; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000382:microbiology; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077336:Caspofungin; D065819:Voriconazole