TY - JOUR 
A1 - Muñoz, Patricia
AU - Vena, Antonio
AU - Cerón, Inés
AU - Valerio Minero, Maricela
AU - Palomo, Jesús
AU - Guinea, Jesús
AU - Escribano Subías, Pilar
AU - Martínez Sellés Oliveria Soares, Manuel
AU - Bouza, Emilio
T1 - Invasive pulmonary aspergillosis in heart transplant recipients: two radiologic patterns with a different prognosis
Y1 - 2014
SN - 10532498
UR - http://hdl.handle.net/11268/4018
AB - Background

Computed tomography (CT) findings can be used to classify invasive pulmonary aspergillosis (IPA) in 2 patterns: airway-invasive (AIR) or angioinvasive (ANG).

Methods

AIR-IPA was considered when the CT revealed peribronchial consolidation or a tree-in-bud pattern and ANG-IPA when a nodule, cavity, halo sign, infarct-shaped, or mass-like consolidation was found. We evaluated the correlation among IPA patterns on CT and outcomes in heart transplant (HT) recipients.

Results

The study included 27 HT recipients with a CT scan performed at the time of IPA diagnosis. The study interval was from 1988 to 2011. Ten AIR-IPA patients (37.1%) were compared with 17 ANG-IPA patients (62.9%). During the post-transplantation period before IPA developed, AIR patients required hemodialysis more frequently (40% vs 5.9%, p = 0.04). AIR patients also had more intercurrent bacterial pneumonia (23.5% vs 70%, p < 0.001), and IPA was diagnosed later after onset of symptoms (2.7 vs 8.5 d, p = 0.09). After diagnosis, AIR-IPA patients required more mechanical ventilation (23.5% vs 90%, p < 0.01) and had a higher related mortality rate (23.5% vs 70%, p = 0.04).

Conclusions

Our study shows that the AIR pattern represents 37% of IPA episodes in HT recipients and is associated with a more protracted clinical presentation, later diagnosis, and higher mortality rate.
KW - Aspergillosis invasiva
KW - Trasplante de corazón
KW - Cardiología
KW - Pulmones - Enfermedades
KW - Aparato respiratorio
KW - Sistema cardiovascular
KW - Enfermedad
LA - eng
ER -