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Aspergillosis in lung transplantation: incidence, risk factors, and prophylactic strategies
Author(s) -
Gordon S.M.,
Avery R.K.
Publication year - 2001
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1034/j.1399-3062.2001.003003161.x
Subject(s) - medicine , aspergillosis , immunosuppression , intensive care medicine , lung transplantation , incidence (geometry) , neutropenia , transplantation , lung , cytomegalovirus , surgery , immunology , human immunodeficiency virus (hiv) , viral disease , chemotherapy , herpesviridae , optics , physics
Invasive aspergillosis remains a significant cause of morbidity and mortality in transplantation, especially lung and allogeneic bone marrow transplant recipients. The epidemiology, classic and newly recognized risk factors, and incidence of aspergillosis are reviewed. Risk factors include environmental exposures, airway colonization, profound immunosuppression, neutropenia, prior cytomegalovirus infection, and renal dysfunction. Clinical and radiographic presentations of invasive aspergillosis are discussed, including some unusual manifestations in lung transplant recipients. Early and accurate diagnosis of aspergillosis remains a challenge, and diagnostic strategies are reviewed, with an emphasis on the chest computerized tomography scan and on transbronchial or open lung biopsy. Recent advances include prophylactic and pre‐emptive antifungal strategies, newer therapeutic agents, and improved risk stratification.