title: Fungal infection in heart transplant recipients with severe sepsis: single-center experience.
abstract: The objective of this study was to describe in heart transplant recipients severe sepsis due to fungal infection, which is associated with high mortality. This was a retrospective study including 366 patients who underwent heart transplantation from 1987 to 2009 in whom severe sepsis due to fungal infection developed, with multiple-organ failure. Sepsis was diagnosed on the basis of a positive culture for the infective agent, such as Cryptococcus, Aspergillus, Candida, or Nocardia, from an appropriate source such as blood, wound, or sputum. In 10 patients, severe sepsis due to fungal infection was treated temporally by reducing or sparing immunosuppression; 7 of these patients survived after intensive care. Only 1 patient required pulsed therapy because of an acute rejection episode. Early diagnosis with aggressive diagnostic techniques and use of combination therapy must be considered to reduce the risk of death in heart transplant recipients with fungal infection.
authors.affiliation: Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: N K
authors.initials: NK
authors.lastname: Chou
authors.forename: N H
authors.initials: NH
authors.lastname: Chi
authors.forename: I W
authors.initials: IW
authors.lastname: Wu
authors.forename: S C
authors.initials: SC
authors.lastname: Huang
authors.forename: Y S
authors.initials: YS
authors.lastname: Chen
authors.forename: H Y
authors.initials: HY
authors.lastname: Yu
authors.forename: C I
authors.initials: CI
authors.lastname: Tsao
authors.forename: W J
authors.initials: WJ
authors.lastname: Ko
authors.forename: H Y
authors.initials: HY
authors.lastname: Sun
authors.forename: S C
authors.initials: SC
authors.lastname: Chang
authors.forename: S H
authors.initials: SH
authors.lastname: Chu
authors.forename: S S
authors.initials: SS
authors.lastname: Wang
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D003422:Critical Care; D004359:Drug Therapy, Combination; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology / Q000628:therapy; D009181:Mycoses / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy / Q000453:epidemiology; D015996:Survival Rate
chemical_list: D000935:Antifungal Agents