Division of Cardiology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
Section of Cardiology, Department of Medicine.
Transplant Proc. 2021 Dec;53(10):3051-3055. doi: 10.1016/j.transproceed.2021.09.034. Epub 2021 Nov 10.
Invasive pulmonary mucormycosis is a potentially fatal infection that can occur in immunosuppressed patients such as those who have undergone orthotopic heart transplant (OHT). High-dose intravenous antifungal agents, including amphotericin B, are generally accepted as the first-line medical treatment, with prompt surgical resection of lesions if feasible. The body of evidence guiding treatment decisions, however, is sparse, particularly regarding adjustment of immunosuppression during acute infection and long-term recovery. We present 2 cases of patients with pulmonary mucormycosis occurring within the first 6 months after OHT, both of whom successfully recovered after appropriate medical and surgical treatment, and we highlight differences in immunosuppression management strategies for this life-threatening condition.
侵袭性肺毛霉病是一种潜在致命的感染，可发生在免疫抑制患者中，如接受原位心脏移植（OHT）的患者。大剂量静脉用抗真菌药物，包括两性霉素 B，通常被认为是一线治疗方法，如果可行，应及时手术切除病变。然而，指导治疗决策的证据很少，特别是在急性感染和长期康复期间调整免疫抑制方面。我们报告了 2 例 OHT 后 6 个月内发生的肺毛霉病患者，他们都在适当的药物和手术治疗后成功康复，我们强调了这种危及生命的疾病的免疫抑制管理策略的差异。
