Lázaro M, Ramos A, Ussetti P, Asensio A, Laporta R, Muñez E, Sánchez-Romero I, Tejerina E, Burgos R, Moñivas V, Varela A
Department of Pneumology, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Madrid, Spain.
Transpl Infect Dis. 2011 Apr;13(2):186-91. doi: 10.1111/j.1399-3062.2010.00589.x.
We present a case of endocarditis caused by Aspergillus in a lung transplant (LT) patient and review 6 previously reported cases. All cases were caused by Aspergillus fumigatus. Five patients (71%) were transplanted due to cystic fibrosis. None of the patients had any previously known valvular heart disease. The time that elapsed between LT surgery and the diagnosis of Aspergillus endocarditis was 8±6 months. Large peripheral emboli were observed in 6 patients (85%); blood cultures were negative in all. Transthoracic echocardiography did not detect the presence of vegetations in 3 patients (43%); the vegetations measured >1.5 cm in all cases. Five patients (71%) died from disseminated disease. Both survivors underwent combined therapy with antifungal drugs and surgical treatment.
我们报告了1例肺移植（LT）患者发生的由曲霉菌引起的心内膜炎病例，并回顾了6例先前报道的病例。所有病例均由烟曲霉菌引起。5例患者（71%）因囊性纤维化接受移植。所有患者既往均无已知的瓣膜性心脏病。LT手术至曲霉菌性心内膜炎诊断的时间为8±6个月。6例患者（85%）观察到较大的外周栓子；所有血培养均为阴性。经胸超声心动图在3例患者（43%）中未检测到赘生物；所有病例中赘生物均大于1.5 cm。5例患者（71%）死于播散性疾病。2例幸存者均接受了抗真菌药物联合手术治疗。
