Mycotic Aneurysm of the Ascending Aorta and Aspergillus Fumigatus Mediastinitis Early after Cardiac Transplantation

Paul R. Vogt, Elisabeth Hasler, Daniel Schmidlin, Pascal Berdat, Phillip Th. Went, Markus Flepp and Paul Mohasci

Department of Cardiovascular Surgery, Klinik Im Park, Switzerland
Department of Pneumology, University Hospital Zurich, Switzerland
Department of Anaesthesia and Intensive Care, Klinik Im Park, Switzerland
Pathology Institute Enge, Switzerland
Department of Infectious Diseases, Klinik Im Park, Switzerland
Department of Cardiology, Klinik Im Park, Switzerland

^*Correspondance to: Paul R. Vogt 

 PDF  Full Text DOI: 10.25107/2474-1647.1681

Abstract

A 66-year old man after orthotopic heart transplantation developed severe infection with Aspergillus fumigates covering the entire thoracic cavity with a thick fungal turf. Repeated surgical removal of infectious and necrotic tissue together with innovative topical treatment using voriconazole and chlorhexidine combined with systemic antifungal treatment lead to elimination of the infection. Definite wound closure was achieved by latissimus dorsi muscle flap plasty and standard sterna refixation. To the best of our knowledge, we report the first survival of extensive A.fumigatus mediastinitis after heart transplantation due to repeated debridement in combination with novel topical application of antifungal agents.

Keywords

Aspergillus fumigatus; Fungal Infection; Heart transplant; Immunosuppression; Mediastinitis; Mycotic aneurysm; Topical treatment; Chlorhexidine; Voriconazole

Cite the article

Vogt PR, Hasler E, Schmidlin D, Berdat P, Went PTh, Flepp M, et al. Mycotic Aneurysm of the Ascending Aorta and Aspergillus Fumigatus Mediastinitis Early after Cardiac Transplantation. Clin Surg. 2017; 2: 1681.