title: Septic-Metastasizing Aspergillus-Encephalitis Mimicking Massive Cerebral Infarction in a Heart Transplant Recipient: A Case Report.
abstract: Invasive fungal infection after solid-organ transplantation is known as a severe complication and carries with it a high risk of infection-related mortality. Among patients after heart transplant Aspergillus species most often cause atypical pneumonia. The incidence of invasive aspergillosis after heart transplant has been reported from 3% to 14%. It is the opportunistic pathogen with the highest mortality, ranging from 50% to 80%. Prompt antifungal therapy is crucial, but rapid diagnostic procedures with sufficient sensitivity and specificity are lacking at the moment. We present a rare case of a patient with massive metastasizing invasive aspergillosis within 1 month after heart transplant, undetected before death.
authors.affiliation: From the 1Department of Cardiovascular Surgery, Heinrich Heine University, Düsseldorf, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Ballázs
authors.forename: Payam
authors.initials: P
authors.lastname: Akhyari
authors.forename: Arash
authors.initials: A
authors.lastname: Mehdiani
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kamiya
authors.forename: Petra
authors.initials: P
authors.lastname: Reinecke
authors.forename: Jörg
authors.initials: J
authors.lastname: Felsberg
authors.forename: Diyar
authors.initials: D
authors.lastname: Saeed
authors.forename: Artur
authors.initials: A
authors.lastname: Lichtenberg
authors.forename: Udo
authors.initials: U
authors.lastname: Boeken
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D002533:Cerebral Angiography / Q000379:methods; D002544:Cerebral Infarction / Q000175:diagnosis*; D003131:Combined Modality Therapy; D000072226:Computed Tomography Angiography; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D017809:Fatal Outcome; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D011237:Predictive Value of Tests; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents