Subacute invasive aspergillosis in CF after heart/lung transplant

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A caucasian female with Cystic Fibrosis required a combined heart and lung transplant at the age of 15. Immunosuppressant therapy was commenced post-transplant. In August 2005, symptomatology and HRCT identified likely multi-focal pulmonary fungal infection. Cultures were negative. Empirical therapy eventually led to symptomatic improvement. This therapy was later discontinued due to the potential interaction with her immunosuppressant drugs. By this stage she had also developed severe chronic rejection; adequate immunosuppression was therefore of profound importance. However, the cessation of antifungal therapy resulted in a progressive return of her symptoms; successive chest x-rays revealed worsening pulmonary lesions. Aspergillus precipitins were positive, consistent with Aspergillus fumigatus as being the causative organism but unfortunately re-initiation of antifungal therapy was unable to prevent her death.


  • Aspergillus fumigatus