Diana F Florescu1, Uriel Sandkovsky. 1. aTransplant Infectious Diseases Program, Division of Infectious Diseases bTransplant Surgery Division, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Abstract
PURPOSE OF REVIEW: Patients who undergo intestinal and multivisceral transplantation are at increased risk for infectious complications. Fungal infections are major causes of morbidity and mortality in these patients. The current review highlights key diagnostic and management issues in this population. RECENT FINDINGS: Invasive infections caused by Candida spp. remain the most common invasive fungal infections in intestinal and multivisceral transplant recipients. Aspergillus is an emerging pathogen but data are limited to case reports or case series. Other fungi including the mucorales, Cryptococcus and endemic mycoses are emerging pathogens but data regarding incidence and timing of disease in intestinal and multivisceral transplant recipients are lacking. SUMMARY: Invasive candidiasis is the most common fungal infection in patients with intestinal and multivisceral transplants. Experience for diagnosis and management comes from case series and single centers. Diagnosis and management of infections caused by other pathogens such as Aspergillus, Cryptococcus, Mucor, and endemic mycoses is usually extrapolated from other solid organ transplant recipients.
PURPOSE OF REVIEW: Patients who undergo intestinal and multivisceral transplantation are at increased risk for infectious complications. Fungal infections are major causes of morbidity and mortality in these patients. The current review highlights key diagnostic and management issues in this population. RECENT FINDINGS:Invasive infections caused by Candida spp. remain the most common invasive fungal infections in intestinal and multivisceral transplant recipients. Aspergillus is an emerging pathogen but data are limited to case reports or case series. Other fungi including the mucorales, Cryptococcus and endemic mycoses are emerging pathogens but data regarding incidence and timing of disease in intestinal and multivisceral transplant recipients are lacking. SUMMARY: Invasive candidiasis is the most common fungal infection in patients with intestinal and multivisceral transplants. Experience for diagnosis and management comes from case series and single centers. Diagnosis and management of infections caused by other pathogens such as Aspergillus, Cryptococcus, Mucor, and endemic mycoses is usually extrapolated from other solid organ transplant recipients.