post lung transplant infections

Spp, species; CMV, cytomegalovirus; EBV, Epstein-Barr virus; VZV, varicella-zoster virus; PCP, Pneumocystis pneumonia.
Lung transplant recipients are at substantial risk for infectious complications, including invasive fungal infections due to the high level of immunosuppression required to prevent rejection of the transplanted lungs, as well as the direct effects of transplantation on host defenses (eg, impaired mucociliary clearance, reduced cough, interrupted lymphatic drainage) (see Figure 1). The most common fungal infections in lung transplant recipients are caused by Aspergillus and Candida species. Candida species can cause a spectrum of disease including nosocomial bloodstream infections, surgical site infections, and airway anastomotic dehiscence resulting in pleural space contamination (as in this patient). Antifungal prophylaxis is recommended by the International Society for Heart and Lung Transplantation and IDSA; however, these infections continue to cause significant morbidity and mortality after lung transplantation and should be treated aggressively.¹

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