Abstract
Between June 1988 and May 1991 88 orthotopic liver transplants and 1 liver and pancreas transplant were performed at the Liver Transplantation Department of the Ospedale Maggiore of Milan. All the patients underwent mycological surveillance and received antifungal prophylaxis with oral amphotericin B (6000 mg/day) or oral or intravenous fluconazole (200 mg/day) from the time of their transplant. The incidence of Candida colonization was 67%. Fluconazole was superior to oral amphotericin B in the treatment of C. albicans colonization (99 vs 15), but less effective in the treatment of colonization by other Candida spp. (03 vs 33). Deep-seated candidiasis developed in 5 patients, caused by C. albicans in 4 cases and C. krusei in 1. C. albicans infection resolved rapidly with fluconazole in 2 subjects, with intravenous amphotericin B alone in 1, and with amphotericin B plus flucytosine in the other. On the contrary, C. krusei infection did not respond to treatment with amphotericin B combined with flucytosine. Aspergillosis was diagnosed in 11 patients, of whom 4 died from invasive aspergillosis, despite 15 and 26 days of amphotericin B treatment in 2. In another patient invasive aspergillosis, diagnosed a few hours before retransplantation, improved with liposomal amphotericin B, but this man died from cytomegalovirus infection one month later. Aspergillosis was eradicated by itraconazole in 4 other patients and by topical amphotericin B in 2 whose infection was localized to surgical wound.
| Original language | English |
|---|---|
| Pages (from-to) | 433-436 |
| Number of pages | 4 |
| Journal | European Journal of Epidemiology |
| Volume | 8 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - May 1992 |
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Keywords
- Antifungal treatment
- Liver transplant
- Opportunistic fungal infections
ASJC Scopus subject areas
- Epidemiology
Cite this
Surveillance and treatment of liver transplant recipients for candidiasis and aspergillosis. / Viviani, M. A.; Tortorano, A. M.; Malaspina, C.; Colledan, M.; Paone, G.; Rossi, G.; Bordone, G.; Pagano, A.
In: European Journal of Epidemiology, Vol. 8, No. 3, 05.1992, p. 433-436.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Surveillance and treatment of liver transplant recipients for candidiasis and aspergillosis
AU - Viviani, M. A.
AU - Tortorano, A. M.
AU - Malaspina, C.
AU - Colledan, M.
AU - Paone, G.
AU - Rossi, G.
AU - Bordone, G.
AU - Pagano, A.
PY - 1992/5
Y1 - 1992/5
N2 - Between June 1988 and May 1991 88 orthotopic liver transplants and 1 liver and pancreas transplant were performed at the Liver Transplantation Department of the Ospedale Maggiore of Milan. All the patients underwent mycological surveillance and received antifungal prophylaxis with oral amphotericin B (6000 mg/day) or oral or intravenous fluconazole (200 mg/day) from the time of their transplant. The incidence of Candida colonization was 67%. Fluconazole was superior to oral amphotericin B in the treatment of C. albicans colonization (99 vs 15), but less effective in the treatment of colonization by other Candida spp. (03 vs 33). Deep-seated candidiasis developed in 5 patients, caused by C. albicans in 4 cases and C. krusei in 1. C. albicans infection resolved rapidly with fluconazole in 2 subjects, with intravenous amphotericin B alone in 1, and with amphotericin B plus flucytosine in the other. On the contrary, C. krusei infection did not respond to treatment with amphotericin B combined with flucytosine. Aspergillosis was diagnosed in 11 patients, of whom 4 died from invasive aspergillosis, despite 15 and 26 days of amphotericin B treatment in 2. In another patient invasive aspergillosis, diagnosed a few hours before retransplantation, improved with liposomal amphotericin B, but this man died from cytomegalovirus infection one month later. Aspergillosis was eradicated by itraconazole in 4 other patients and by topical amphotericin B in 2 whose infection was localized to surgical wound.
AB - Between June 1988 and May 1991 88 orthotopic liver transplants and 1 liver and pancreas transplant were performed at the Liver Transplantation Department of the Ospedale Maggiore of Milan. All the patients underwent mycological surveillance and received antifungal prophylaxis with oral amphotericin B (6000 mg/day) or oral or intravenous fluconazole (200 mg/day) from the time of their transplant. The incidence of Candida colonization was 67%. Fluconazole was superior to oral amphotericin B in the treatment of C. albicans colonization (99 vs 15), but less effective in the treatment of colonization by other Candida spp. (03 vs 33). Deep-seated candidiasis developed in 5 patients, caused by C. albicans in 4 cases and C. krusei in 1. C. albicans infection resolved rapidly with fluconazole in 2 subjects, with intravenous amphotericin B alone in 1, and with amphotericin B plus flucytosine in the other. On the contrary, C. krusei infection did not respond to treatment with amphotericin B combined with flucytosine. Aspergillosis was diagnosed in 11 patients, of whom 4 died from invasive aspergillosis, despite 15 and 26 days of amphotericin B treatment in 2. In another patient invasive aspergillosis, diagnosed a few hours before retransplantation, improved with liposomal amphotericin B, but this man died from cytomegalovirus infection one month later. Aspergillosis was eradicated by itraconazole in 4 other patients and by topical amphotericin B in 2 whose infection was localized to surgical wound.
KW - Antifungal treatment
KW - Liver transplant
KW - Opportunistic fungal infections
UR - http://www.scopus.com/inward/record.url?scp=0026786421&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0026786421&partnerID=8YFLogxK
U2 - 10.1007/BF00158579
DO - 10.1007/BF00158579
M3 - Article
C2 - 1397207
AN - SCOPUS:0026786421
VL - 8
SP - 433
EP - 436
JO - European Journal of Epidemiology
JF - European Journal of Epidemiology
SN - 0393-2990
IS - 3
ER -