Post-operative Aspergillus mediastinitis in a man who was immunocompetent: a case report.
BACKGROUND
Aspergillus spp. infections mainly affect patients who are immunocompromised, and are extremely rare in immunocompetent individuals.


METHODS
Aspergillus post-operative mediastinitis is considered to be a devastating infection, usually affecting patients undergoing cardiothoracic surgery with specific predisposing factors. We describe the case of an immunocompetent 68-year-old Caucasian man with severe chronic thromboembolic pulmonary hypertension, who underwent pulmonary thromboendarterectomy and developed post-operative mediastinitis due to Aspergillus flavus. The environmental control did not reveal the source of A. flavus infection and, despite combined antifungal therapy, our patient died as a result of septic shock and multiple organ failure.


CONCLUSIONS
Aspergillus mediastinitis mainly affects patients after cardiosurgery operations with predisposing factors, and it is unusual in patients who are immunocompetent. The identification of the Aspergillus spp. source is often difficult, and there are no guidelines for the administration of pre-emptive therapy in this population of at-risk patients.
Dimopoulos
George
G
Second Department of Critical Care Medicine, 'ATTIKON' University Hospital, University of Athens Medical School, Athens Greece. dimop@vodafone.net.gr.
Tsangaris
Iraklis
I
Poulakou
Garyphalia
G
Panayiotides
John
J
Tsaknis
George
G
Orfanos
Stylianos
S
Armaganides
Apostolos
A