title: Mediastinal mass due to Aspergillus fumigatus after lung transplantation: a case report.
abstract: We report a rare case of mediastinal mass caused by Aspergillus fumigatus in a lung transplant recipient. The patient presented 9 months after bilateral lung transplantation for cystic fibrosis with intermittent fevers and new onset atrial fibrillation/flutter caused by a 7-cm mediastinal mass invading the left atrium. The mass was resected, and a prolonged course of voriconazole and caspofungin was given, which resulted in a complete clinical response. Despite long-term suppressive therapy with voriconazole, a relapse occurred 16 months after the initial diagnosis. This case highlights the challenges in the prevention and treatment of invasive aspergillosis in lung transplant recipients.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Johns Hopkins Medical Institutes, Baltimore, Maryland 21230, USA. oshlobil@jhmi.edu
authors.forename: Oksana Anatolia
authors.initials: OA
authors.lastname: Shlobin
authors.forename: Lesia K
authors.initials: LK
authors.lastname: Dropulic
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Orens
authors.forename: John F
authors.initials: JF
authors.lastname: Mcdyer
authors.forename: John V
authors.initials: JV
authors.lastname: Conte
authors.forename: Stephen Y
authors.initials: SY
authors.lastname: Yang
authors.forename: Reda
authors.initials: R
authors.lastname: Girgis
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy; D001232:Aspergillus fumigatus; D000077336:Caspofungin; D003550:Cystic Fibrosis / Q000601:surgery; D004359:Drug Therapy, Combination; D054714:Echinocandins; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D055666:Lipopeptides; D016040:Lung Transplantation; D008279:Magnetic Resonance Imaging; D008477:Mediastinal Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D010456:Peptides, Cyclic / Q000627:therapeutic use; D011183:Postoperative Complications / Q000382:microbiology*; D011743:Pyrimidines / Q000627:therapeutic use; D012008:Recurrence; D013906:Thoracoscopy; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D014230:Triazoles; D000666:Amphotericin B; D000077336:Caspofungin; D065819:Voriconazole