Caspofungin-resistant Aspergillus flavus after heart transplantation and mechanical circulatory support: a case report.
Invasive aspergillosis (IA) is a severe complication in the post-transplant period in recipients of solid organs. Therefore, early diagnosis and specific therapy of fungal infections in these patients are indispensable. We report the case of a 49-year-old patient, who suffered from IA after cardiac transplantation, which was complicated by post-transplant right heart failure requiring mechanical circulatory support using veno-arterial extracorporeal membrane oxygenation and a right ventricular assist device. Despite antifungal treatment, the patient died 3 weeks after transplantation because of multi-organ failure secondary to IA. The isolated Aspergillus strains exhibited in vitro resistance to caspofungin.
Eschertzhuber
S
S
Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria. stephan.eschertzhuber@uibk.ac.at
Velik-Salchner
C
C
Hoermann
C
C
Hoefer
D
D
Lass-Florl
C
C
D000935:Antifungal Agents / Q000494:pharmacology*; D001228:Aspergillosis / Q000188:drug therapy / Q000209:etiology*; D001231:Aspergillus flavus / Q000187:drug effects*; D000077336:Caspofungin; D025141:Drug Resistance, Fungal; D054714:Echinocandins / Q000494:pharmacology*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006353:Heart-Assist Devices; D006801:Humans; D055666:Lipopeptides; D008875:Middle Aged; D011743:Pyrimidines / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D000077336:Caspofungin; D065819:Voriconazole