title: Invasive pulmonary aspergillosis in heart transplant recipients.
abstract: OBJECTIVE
  Invasive pulmonary aspergillosis is the most common invasive mycosis in heart transplant recipients. Early clinical recognition of this complication is difficult and laboratory data is not specific. Our aim was to study the characteristics of invasive pulmonary aspergillosis infections in heart transplant recipients.
  
  
  METHODS
  Between 2007 and 2013, there were 82 patients who underwent heart transplant at our institution, including 6 patients who were diagnosed with invasive pulmonary aspergillosis. Medical records of these patients were reviewed for demographic, clinical, and radiographic features, microbiology data, serum galactomannan levels, antifungal treatment, and overall outcomes.
  
  
  RESULTS
  The most common species causing the infection was Aspergillus fumigatus. The infection was encountered irrespective of the duration since the transplant. Bronchoalveolar lavage with positive culture for Aspergillus species and/or abnormal serum galactomannan level was suggestive of invasive pulmonary aspergillosis.
  
  
  CONCLUSIONS
  In our opinion, empiric antifungal therapy should be commenced as soon as invasive pulmonary aspergillosis is suspected in heart transplant recipients to reduce mortality. Although the duration of antifungal therapy for invasive pulmonary aspergillosis is debatable, heart transplant recipients may require long-term therapy to avoid recurrence.
authors.affiliation: From the Departments of Pulmonary Diseases, Baskent University School of Medicine, Ankara, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Küpeli
authors.forename: Gaye
authors.initials: G
authors.lastname: Ulubay
authors.forename: Sevil
authors.initials: S
authors.lastname: Bayram Akkurt
authors.forename: Füsun
authors.initials: F
authors.lastname: Öner Eyüboğlu
authors.forename: Atilla
authors.initials: A
authors.lastname: Sezgin
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001230:Aspergillus / Q000145:classification / Q000302:isolation & purification*; D015415:Biomarkers / Q000097:blood; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D008168:Lung / Q000382:microbiology*; D008297:Male; D008351:Mannans / Q000097:blood; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D000935:Antifungal Agents; D015415:Biomarkers; D007166:Immunosuppressive Agents; D008351:Mannans; C012990:galactomannan; D005690:Galactose