Mediastinal mass due to Aspergillus fumigatus after lung transplantation: a case report.
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.
Shlobin
Oksana Anatolia
OA
Department of Pulmonary and Critical Care Medicine, Johns Hopkins Medical Institutes, Baltimore, Maryland 21230, USA. oshlobil@jhmi.edu
Dropulic
Lesia K
LK
Orens
Jonathan B
JB
Mcdyer
John F
JF
Conte
John V
JV
Yang
Stephen Y
SY
Girgis
Reda
R
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
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