Abstract
Infection continues to be a major cause of mortality in cardiac transplant patients, and even though there has been significant progress in diagnosing and treating many infectious disease problems, invasive aspergillosis in the transplant patient represents a serious and usually fatal complication. Even with successful early diagnosis, the use of free amphotericin B (a polyene antibiotic) has failed to cure disseminated infection. We report the case of a 46-year-old transplant patient who failed to respond to treatment with free amphotericin B after a 7-day period of treatment for biopsy-proven pulmonary aspergillosis. However, a subsequent substitution of a liposomal form of amphotericin B was used, and the patient responded well to a total dose of 1.5 mg. After 7 months, the patient continues free of infection. This experience suggests that the introduction of liposomal amphotericin B may give new hope for treating an otherwise lethal infection.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Duma R. J. Unusual infections in transplant patients. Transplant Proc. 1972 Dec;4(4):711–715. [PubMed] [Google Scholar]
- Gurwith M. J., Stinson E. B., Remington J. S. Aspergillus infection complicating cardiac transplantation. Report of five cases. Arch Intern Med. 1971 Oct;128(4):541–545. [PubMed] [Google Scholar]
- Lopez-Berestein G., Fainstein V., Hopfer R., Mehta K., Sullivan M. P., Keating M., Rosenblum M. G., Mehta R., Luna M., Hersh E. M. Liposomal amphotericin B for the treatment of systemic fungal infections in patients with cancer: a preliminary study. J Infect Dis. 1985 Apr;151(4):704–710. doi: 10.1093/infdis/151.4.704. [DOI] [PubMed] [Google Scholar]
- Lopez-Berestein G., Hopfer R. L., Mehta R., Mehta K., Hersh E. M., Juliano R. L. Prophylaxis of Candida albicans infection in neutropenic mice with liposome-encapsulated amphotericin B. Antimicrob Agents Chemother. 1984 Mar;25(3):366–367. doi: 10.1128/aac.25.3.366. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stinson E. B., Bieber C. P., Griepp R. B., Clark D. A., Shumway N. E., Remington J. S. Infectious complications after cardiac transplantation in man. Ann Intern Med. 1971 Jan;74(1):22–36. doi: 10.7326/0003-4819-74-1-22. [DOI] [PubMed] [Google Scholar]