Airway complication contributing to disseminated fusariosis after lung transplantation

J. M. Terasaki, S. K. Shah, V. J. Schnadig, V. G. Valentine

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Fungal infections are common after lung transplantation. However, disseminated fusariosis is rare and we report the first case of airway complications associated with this infectious process. A 77-year-old Caucasian woman, who was status post left single-lung transplant for emphysema, presented to clinic 8 months after lung transplantation with pleurisy, shortness of breath, and declining lung function. Bronchoscopy showed narrowing of the left anastomotic site with dynamic compression during exhalation. An AERO stent was deployed successfully, but 3 weeks later, her symptoms recurred. Bronchoscopy showed total stent occlusion with thick tenacious mucus. Fusarium solani was isolated from cultures, and a new 1.5 cm skin nodule was found on the anteromedial midportion of the patient's left lower leg. Voriconazole and anidulafungin were started. No evidence of mucus accumulation was seen during a follow-up bronchoscopy. It is likely that Fusarium infection contributed to the initial anastomotic complication as well as to obstruction of the stent. Furthermore, the stent may have contributed to establishment and development of disseminated fusariosis. With antifungal therapy, stent patency was maintained and the patient improved clinically.

Original languageEnglish (US)
Pages (from-to)621-624
Number of pages4
JournalTransplant Infectious Disease
Volume16
Issue number4
DOIs
StatePublished - Aug 2014

Keywords

  • Disseminated fusarium
  • Endobronchial stent complication
  • Fusariosis
  • Fusarium
  • Lung transplant

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases
  • Medicine(all)

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