title: Combination antifungal therapy for invasive pulmonary aspergillosis in a heart transplant recipient.
abstract: Invasive pulmonary aspergillosis is a severe complication after solid organ transplant, with a high mortality rate. We present a 45-year-old male heart transplant recipient who developed fever, progressive worsening of dyspnea, and productive cough without response to antibiotics. Diagnosis of invasive pulmonary aspergillosis was made based on clinical, laboratory, and radiographic findings. The patient was treated successfully with combined antifungal therapy (voriconazole and micafungin). This case report highlights the importance of a high degree of clinical suspicion to allow curative treatment of invasive aspergillosis and the efficiency of new antifungal drugs.
authors.affiliation: Department of Cardiac Surgery, Klinikum Grosshadern, Ludwig- Maximilians-University, D-81377 Munich, Germany. abeiras@med.uni-muenchen.de
authors.forename: Andres
authors.initials: A
authors.lastname: Beiras-Fernandez
authors.forename: Amir K
authors.initials: AK
authors.lastname: Bigdeli
authors.forename: Thomas
authors.initials: T
authors.lastname: Nickel
authors.forename: Sebastian
authors.initials: S
authors.lastname: Michel
authors.forename: Peter
authors.initials: P
authors.lastname: Ueberfuhr
authors.forename: Bruno
authors.initials: B
authors.lastname: Reichart
authors.forename: Ingo
authors.initials: I
authors.lastname: Kaczmarek
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000627:therapeutic use*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D055744:Invasive Pulmonary Aspergillosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology; D055666:Lipopeptides / Q000627:therapeutic use*; D008297:Male; D000077551:Micafungin; D008875:Middle Aged; D011743:Pyrimidines / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole; D000077551:Micafungin