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Cytomegalovirus and Aspergillus spp. coinfection in organ transplantation: a case report and review of the literature

With the advent of potent immunosuppressive options, acute rejection episodes have decreased at the expense of increased incidence of opportunistic infections in solid organ recipients. In the absence of any preventive therapy, 30–75 % of transplant recipients develop cytomegalovirus (CMV) infection...

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Autores principales: Solak, Yalcin, Biyik, Zeynep, Cizmecioglu, Ahmet, Genc, Nejdet, Ozbek, Orhan, Gaipov, Abduzhappar, Yeksan, Mehdi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Japan 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413728/
https://www.ncbi.nlm.nih.gov/pubmed/28509226
http://dx.doi.org/10.1007/s13730-012-0040-3
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author Solak, Yalcin
Biyik, Zeynep
Cizmecioglu, Ahmet
Genc, Nejdet
Ozbek, Orhan
Gaipov, Abduzhappar
Yeksan, Mehdi
author_facet Solak, Yalcin
Biyik, Zeynep
Cizmecioglu, Ahmet
Genc, Nejdet
Ozbek, Orhan
Gaipov, Abduzhappar
Yeksan, Mehdi
author_sort Solak, Yalcin
collection PubMed
description With the advent of potent immunosuppressive options, acute rejection episodes have decreased at the expense of increased incidence of opportunistic infections in solid organ recipients. In the absence of any preventive therapy, 30–75 % of transplant recipients develop cytomegalovirus (CMV) infection. Candida spp. and Aspergillus spp. account for more than 80 % of invasive fungal infections in solid organ recipients. This co-occurrence of two commonly seen opportunistic infections may end up in fatality. Here, we present a case of concomitant Aspergillus spp. and CMV infection and discuss the relevant literature. A 54-year-old male patient presented with fever, shortness of breath, and chest pain on the 9th posttransplant week after renal transplantation. CMV-DNA by polymerase chain reaction (PCR) was 1,680,000 copies/ml, thus, valganciclovir dose was increased. There were inspiratory crackles at both lung bases, and chest computed tomography (CT) revealed multiple fungal balls throughout the right lung. Galactomannan antigen was positive, and voriconazole and other antimicrobials were subsequently added to the treatment. At the end of the therapy, on control CT, pneumonic consolidation had disappeared, sputum cultures didn’t show Aspergillus spp., and CMV-DNA reduced to 700 copies/ml. The patient showed a favorable clinical response to combined treatment; fever, dyspnea, and pleuritic chest pain disappeared. Both CMV disease and aspergillosis may present as pulmonary disease; thus, the characterization of one may not preclude the search for the other and the timely initiation of treatment is of paramount importance for good outcomes.
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spelling pubmed-54137282017-05-03 Cytomegalovirus and Aspergillus spp. coinfection in organ transplantation: a case report and review of the literature Solak, Yalcin Biyik, Zeynep Cizmecioglu, Ahmet Genc, Nejdet Ozbek, Orhan Gaipov, Abduzhappar Yeksan, Mehdi CEN Case Rep Case Report With the advent of potent immunosuppressive options, acute rejection episodes have decreased at the expense of increased incidence of opportunistic infections in solid organ recipients. In the absence of any preventive therapy, 30–75 % of transplant recipients develop cytomegalovirus (CMV) infection. Candida spp. and Aspergillus spp. account for more than 80 % of invasive fungal infections in solid organ recipients. This co-occurrence of two commonly seen opportunistic infections may end up in fatality. Here, we present a case of concomitant Aspergillus spp. and CMV infection and discuss the relevant literature. A 54-year-old male patient presented with fever, shortness of breath, and chest pain on the 9th posttransplant week after renal transplantation. CMV-DNA by polymerase chain reaction (PCR) was 1,680,000 copies/ml, thus, valganciclovir dose was increased. There were inspiratory crackles at both lung bases, and chest computed tomography (CT) revealed multiple fungal balls throughout the right lung. Galactomannan antigen was positive, and voriconazole and other antimicrobials were subsequently added to the treatment. At the end of the therapy, on control CT, pneumonic consolidation had disappeared, sputum cultures didn’t show Aspergillus spp., and CMV-DNA reduced to 700 copies/ml. The patient showed a favorable clinical response to combined treatment; fever, dyspnea, and pleuritic chest pain disappeared. Both CMV disease and aspergillosis may present as pulmonary disease; thus, the characterization of one may not preclude the search for the other and the timely initiation of treatment is of paramount importance for good outcomes. Springer Japan 2012-11-09 /pmc/articles/PMC5413728/ /pubmed/28509226 http://dx.doi.org/10.1007/s13730-012-0040-3 Text en © Japanese Society of Nephrology 2012
spellingShingle Case Report
Solak, Yalcin
Biyik, Zeynep
Cizmecioglu, Ahmet
Genc, Nejdet
Ozbek, Orhan
Gaipov, Abduzhappar
Yeksan, Mehdi
Cytomegalovirus and Aspergillus spp. coinfection in organ transplantation: a case report and review of the literature
title Cytomegalovirus and Aspergillus spp. coinfection in organ transplantation: a case report and review of the literature
title_full Cytomegalovirus and Aspergillus spp. coinfection in organ transplantation: a case report and review of the literature
title_fullStr Cytomegalovirus and Aspergillus spp. coinfection in organ transplantation: a case report and review of the literature
title_full_unstemmed Cytomegalovirus and Aspergillus spp. coinfection in organ transplantation: a case report and review of the literature
title_short Cytomegalovirus and Aspergillus spp. coinfection in organ transplantation: a case report and review of the literature
title_sort cytomegalovirus and aspergillus spp. coinfection in organ transplantation: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413728/
https://www.ncbi.nlm.nih.gov/pubmed/28509226
http://dx.doi.org/10.1007/s13730-012-0040-3
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