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editorial
. 2011 Mar 17;30(4):361–374. doi: 10.1016/j.healun.2011.01.701

Table 4c.

Fungal Bronchial Anastomotic Infection in Lung Transplant Recipients

Syndromea Signs/symptoms Radiology Laboratory

  • Bronchial anastomotic infection

  • Proven:

  • Histology (biopsy showing histologic evidence of invasion by fungal hyphae or pseudohyphae) or positive culture from the sterile tissue ALONE; OR with sign/symptoms + radiology + laboratory

  • Probable:

  • Sign/symptoms + radiology + laboratory + negative histology

  • At least one of the following:

  •  • New onset of purulent sputum OR change In character OR quantity of sputum OR respiratory secretions suctioned

  •  • New-onset or worsening cough, dyspnea, tachypnea, or bronchial breath sounds

  • AND endobronchial lesions restricted to the site of anastomosis without clinical or histologic involvement of other parts of bronchial tree or lung parenchyma (Figure 1b)

  • Chest radiograph without:

  •  • New or progressive and persistent infiltrate

  •  • Consolidation

  •  • Cavitation

  •  • Nodules

  • OR CT scan without:

  •  • New or progressive and persistent infiltrate

  •  • Consolidation

  •  • Cavitation

  •  • Nodules

 Single positive culture for mold in BAL OR single positive PCR for mold in BAL OR positive galactomannan in the BAL OR at least TWO positive sputum cultures/PCRs of fungal organisms (excluding Candida species)
a

In the absence of biopsy categorize as probable: In the presence of histologic findings of both acute rejection and fungal invasion it should be classified as acute rejection with proven fungal infection.