title: Pulmonary zygomycosis in solid organ transplant recipients in the current era.
abstract: 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.
authors.affiliation: VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
authors.forename: H-Y
authors.initials: HY
authors.lastname: Sun
authors.forename: J M
authors.initials: JM
authors.lastname: Aguado
authors.forename: H
authors.initials: H
authors.lastname: Bonatti
authors.forename: G
authors.initials: G
authors.lastname: Forrest
authors.forename: K L
authors.initials: KL
authors.lastname: Gupta
authors.forename: N
authors.initials: N
authors.lastname: Safdar
authors.forename: G T
authors.initials: GT
authors.lastname: John
authors.forename: K J
authors.initials: KJ
authors.lastname: Pursell
authors.forename: P
authors.initials: P
authors.lastname: Muñoz
authors.forename: R
authors.initials: R
authors.lastname: Patel
authors.forename: J
authors.initials: J
authors.lastname: Fortun
authors.forename: P
authors.initials: P
authors.lastname: Martin-Davila
authors.forename: B
authors.initials: B
authors.lastname: Philippe
authors.forename: F
authors.initials: F
authors.lastname: Philit
authors.forename: A
authors.initials: A
authors.lastname: Tabah
authors.forename: N
authors.initials: N
authors.lastname: Terzi
authors.forename: V
authors.initials: V
authors.lastname: Chatelet
authors.forename: S
authors.initials: S
authors.lastname: Kusne
authors.forename: N
authors.initials: N
authors.lastname: Clark
authors.forename: E
authors.initials: E
authors.lastname: Blumberg
authors.forename: M B
authors.initials: MB
authors.lastname: Julia
authors.forename: A
authors.initials: A
authors.lastname: Humar
authors.forename: S
authors.initials: S
authors.lastname: Houston
authors.forename: C
authors.initials: C
authors.lastname: Lass-Florl
authors.forename: L
authors.initials: L
authors.lastname: Johnson
authors.forename: E R
authors.initials: ER
authors.lastname: Dubberke
authors.forename: M A
authors.initials: MA
authors.lastname: Barron
authors.forename: O
authors.initials: O
authors.lastname: Lortholary
authors.forename: N
authors.initials: N
authors.lastname: Singh
mesh_terms: 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*
chemical_list: D000935:Antifungal Agents