Submitted by ROrritt on 3 January 2018
A group of scientists have described an outbreak of Invasive Aspergillosis (IA) in heart transplant recipients. This scenario in not uncommon, and has been linked to construction work in hospitals. The paper describes seven cases seen over a ten month period, and discusses screening strategies in the context of an IA outbreak.
Five of the seven patients described received chest CT scans as part of a diagnostic workup, whereas the remaining two cases were identified by screening other heart transplant recipients for IA using chest CT scans.
In addition to the screening protocol, heart transplant patients admitted after the outbreak was identified received antifungal prophylaxis whilst they were hospitalised (50mg/day intravenous amphotericin B), and for 3months after their discharge (20mg/day inhaled amphotericin B).
The researchers note that the patients diagnosed with IA via screening achieved full response to treatment at 12 weeks, whereas those diagnosed after presentation of symptoms achieved only partial response in the same time frame, or failed to respond to treatment. However, this apparent difference could be due to differences in the patients, their respective infections, or their treatment, rather than early diagnosis.
The researchers conclude that CT scans of the chest might help to detect IA earlier in heart transplant recipients, which could improve outcomes for these patients. But the best strategies for screening and prophylaxis remain unclear.
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