Pulmonary zygomycosis in solid organ transplant recipients in the current era

H. Y. Sun, J. M. Aguado, H. Bonatti, G. Forrest, K. L. Gupta, N. Safdar, G. T. John, K. J. Pursell, P. Muñoz, R. Patel, J. Fortun, P. Martin-Davila, B. Philippe, F. Philit, A. Tabah, N. Terzi, V. Chatelet, S. Kusne, N. Clark, E. BlumbergM. B. Julia, A. Humar, S. Houston, C. Lass-Florl, L. Johnson, E. R. Dubberke, M. A. Barron, O. Lortholary, N. Singh

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50 Scopus citations

Abstract

Fifty-eight solid organ transplant recipients with zygomycosis were studied to assess the presentation, radiographic characteristics, risks for extra-pulmonary dissemination and mortality of pulmonary zygomycosis. Pulmonary zygomycosis was documented in 31 patients (53%) and developed a median of 5.5 months (interquartile range, 2-11 months) posttransplantation. In all, 74.2% (23/31) of the patients had zygomycosis limited to the lungs and 25.8% (8/31) had lung disease as part of disseminated zygomycosis; cutaneous/soft tissue (50%, 4/8) was the most common site of dissemination. Pulmonary disease presented most frequently as consolidation/mass lesions (29.0%), nodules (25.8%) and cavities (22.6%). Patients with disseminated disease were more likely to have Mycocladus corymbifer as the causative pathogen. The mortality rate at 90 days after the treatment was 45.2%. In summary, pulmonary zygomycosis is the most common manifestation in solid organ transplant recipients with zygomycosis, and disseminated disease often involves the cutaneous/soft tissue sites but not the brain.

Original languageEnglish
Pages (from-to)2166-2171
Number of pages6
JournalAmerican Journal of Transplantation
Volume9
Issue number9
DOIs
StatePublished - Sep 1 2009

Keywords

  • Pulmonary infection
  • Transplant
  • Zygomycosis

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