Pulmonary zygomycosis in solid organ transplant recipients in the current era.
Fifty-eight solid organ transplant recipients with zygomycosis were studied to assess the presentation, radiographic characteristics, risks for extra-pulmonary dissemination and mortality of pulmonary zygomycosis. Pulmonary zygomycosis was documented in 31 patients (53%) and developed a median of 5.5 months (interquartile range, 2-11 months) posttransplantation. In all, 74.2% (23/31) of the patients had zygomycosis limited to the lungs and 25.8% (8/31) had lung disease as part of disseminated zygomycosis; cutaneous/soft tissue (50%, 4/8) was the most common site of dissemination. Pulmonary disease presented most frequently as consolidation/mass lesions (29.0%), nodules (25.8%) and cavities (22.6%). Patients with disseminated disease were more likely to have Mycocladus corymbifer as the causative pathogen. The mortality rate at 90 days after the treatment was 45.2%. In summary, pulmonary zygomycosis is the most common manifestation in solid organ transplant recipients with zygomycosis, and disseminated disease often involves the cutaneous/soft tissue sites but not the brain.
Sun
H-Y
HY
VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Aguado
J M
JM
Bonatti
H
H
Forrest
G
G
Gupta
K L
KL
Safdar
N
N
John
G T
GT
Pursell
K J
KJ
Muñoz
P
P
Patel
R
R
Fortun
J
J
Martin-Davila
P
P
Philippe
B
B
Philit
F
F
Tabah
A
A
Terzi
N
N
Chatelet
V
V
Kusne
S
S
Clark
N
N
Blumberg
E
E
Julia
M B
MB
Humar
A
A
Houston
S
S
Lass-Florl
C
C
Johnson
L
L
Dubberke
E R
ER
Barron
M A
MA
Lortholary
O
O
Singh
N
N
D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000188:drug therapy; D013997:Time Factors; D016896:Treatment Outcome; D020096:Zygomycosis / Q000188:drug therapy* / Q000209:etiology*
D000935:Antifungal Agents