Mold infections in lung transplants

Autores de IIS La Fe

• Amparo Solé Jover

  Autor

Participantes ajenos a IIS La Fe

• Ussetti, P

Grupos

• Infección Grave

  

  Investigador Principal

  María Ángeles Tormo Mas

Abstract

Invasive infections by molds, mainly Aspergillus infections, account for more than 10% of infectious complications in lung transplant recipients. These infections have a bimodal presentation: an early one, mainly invading bronchial airways, and a late one, mostly focused on lung or disseminated. The Aspergillus colonization at any time in the post-transplant period is one of the major risk factors. Late colonization, together with chronic rejection, is one of the main causes of late invasive forms. A galactomannan value of 0.5 in bronchoalveolar lavage is currently considered a predictive factor of pulmonary invasive infection. There is no universal strategy in terms of prophylaxis. Targeted prophylaxis and preemptive treatment instead of universal prophylaxis, are gaining more followers. The therapeutic drug monitoring level of azoles is highly recommended in the treatment. Monotherapy with voriconazole is the treatment of choice in invasive aspergillosis; combined antifungal therapies are only recommended in severe, disseminated, and other infections due to non-Aspergillus molds. (C) 2014 Revista Iberoamericana de Micologia. Published by Elsevier Espana, S.L.U. All rights reserved.

Keywords

• Mold infections; Aspergillus; Lung transplant; Chronic rejection; Risk factors