Infection after lung transplantation
Paradis IL, Williams P
Conclusions Isolation of NTM or Aspergillus species from lung transplant recipients is uncommon. Adequate pre-transplant control and post-transplant management of NTM and Aspergillus infections allows for safe lung transplantation.
We present a case of primary Aspergillus appendicitis diagnosed by histologic examination in a patient who underwent lung transplantation.
Infections remain an important risk factor for chronic lung allograft dysfunction (CLAD) and mortality following lung transplantation. In particular, Pseudomonas aeruginosa, Aspergillus fumigatus, respiratory viruses and cytomegalovirus remain published risk factors for CLAD. Recent studies have shown that plasma levels of the donor fraction of cell free DNA (%ddcfDNA) are increased during episodes of acute lung rejection and other allograft injury. We hypothesize that plasma %ddcfDNA may be higher in subjects with pathogen associated allograft injury.
Dectin-1 is a pattern-recognition receptor encoded by the CLEC7A gene. Cytokine expression triggered by Dectin-1 activation is integral to early pathogen-specific responses. rs16910526 is a CLEC7A single nucleotide polymorphism (SNP) associated with increased risk of invasive fungal disease. Defective pathogen-specific immune responses lead to chronic immune activation. Aspergillus colonization increases the risk of chronic lung allograft dysfunction (CLAD) and death. We hypothesized that rs16910526 polymorphisms yielding decreased Dectin-1 protein expression would reduce CLAD-free survival.
We studied cytokine patterns predictive of subsequent invasive aspergillosis (IA) in lung transplant recipients (LTRs) with Aspergillus spp (Asp) colonization post-transplant.
Necrotizing bronchial dehiscence following lung transplantation is a rare and deadly complication with no strict management consensus. Here, we report the case of a patient who underwent bilateral sequential lung transplantation for cystic fibrosis through a clamshell incision and developed, on postoperative day 17, complete bilateral anastomotic dehiscence. The latter was attributed to a Pseudomonas aeruginosa and Aspergillus necrotizing infection. The patient was managed surgically using a bilateral posterolateral thoracotomy approach with resection of the bronchial margins, end-to-end re-anastomosis and intercostal muscle coverage.
Glória Teixeira Sousa, Cristina Cunha, Yan Liu, Ten Feizi, Axel A. Brakhage, Kyung J. Kwon-Chung, Neil A. R. Gow, Matteo Zanda, Monica Piras, Chiara Zanato, Martin Jaeger, Mihai G. Netea, Frank L. van de Veerdonk, João F. Lacerda, António Campos, Agostinho Carvalho, Janet A. Willment, Jean-Paul Latgé &Gordon D. Brown Resistance to infection is critically dependent on the ability of pattern recognition receptors to recognize microbial invasion and induce protective immune responses. One such family of receptors are the C-type lectins, which are central to antifungal immunity. These recept...
We report a case of successful treatment of probable invasive pulmonary aspergillosis due to A. lentulus and polymicrobial infection with Pseudomonas aeruginosa in a patient with relapsing granulomatosis with polyangiitis and recent high-dose steroid therapy.
We report that microhemorrhage-related iron content may be a major determinant of A. fumigatus invasion and, consequently, its virulence. Invasive growth was increased during progressive alloimmune-mediated graft rejection associated with high concentrations of ferric iron in the graft. The role of iron in A. fumigatus invasive growth was further confirmed by showing that this invasive phenotype was increased in tracheal transplants from donor mice lacking the hemochromatosis gene (Hfe–/–). The invasive phenotype was also increased in mouse syngrafts treated with topical iron solution and in allograft recipient...
Cryptococcus neoformans (wikipedia.org) 2.5 out of 5 stars Cryptococcal meningitis in a daily cannabis smoker without evidence of immunodeficiency. Shapiro BB et al. BMJ Case Rep 2018 Jan 26 [Epub ahead of print] Abstract Can smoking marijuana cause meningitis? The question is not unreasonable. A wide range of pathogenic fungi — including Aspergillus and various Cryptococcus species — have been isolated from dispensary-grade medical marijuana samples. Concern that these pathogens could cause pneumonia or central nervous system infections has focussed on those with immunodeficiency, such...