An unusual presentation of invasive aspergillosis after lung transplantation

Etiological agents of fungal endophthalmitis: diagnosis and management

Endophthalmitis caused by fungi is commonly diagnosed around the world in apparently healthy and immunocompromised individuals. An accurate clinical diagnosis for endophthalmitis confirmed by laboratory techniques is essential for early treatment with antifungal drugs, such as amphotericin B, imidazoles, and other antifungals. Here, we review endophthalmitis caused by fungi according to its classification into endogenous fungal endophthalmitis (EFE) and exogenous fungal endophthalmitis (EXFE). EFE is caused by endogenously acquired fungi, whereas the traumatic implantation of opportunistic fungal pathogens is the main feature of EXFE. We highlight the most important etiologies causing endophthalmitis and the steps required for a rapid diagnosis and management.

Central airways obstruction due to Aspergillus fumigatus after lung transplantation

Aspergillus fumigatus may affect immunocompromised lung transplant patients in many ways. We report a new pulmonary manifestation of A fumigatus in 3 patients who underwent bilateral lung transplantation. All 3 subjects developed rapid decreases in pulmonary function and were found to have large central airways obstruction with thick plugs of mucus, heavily laden with Aspergillus species. All 3 patients presented with atypical features of Aspergillus infection, but all responded to treatments with either steroids, anti-fungals or both.

Disseminated Aspergillus fumigatus Infection with Consecutive Mitral Valve Endocarditis in a Lung Transplant Recipient

Aspergillus infection is a known complication of lung transplantation and remains associated with high mortality rates. The manifestation of the infection varies from simple colonization of the lung to disseminated complicated infections. Early Aspergillus infection has been rarely observed in a small number of lung transplant recipients; most cases occur during the late post-operative period. The pulmonary involvement has often been described as the first clinical localization of the disease. Although other various forms of Aspergillus infection are not uncommonly encountered after lung transplantation, Aspergillus mitral valve endocarditis is rare. We present a case of disseminated Aspergillus fumigatus infection with consecutive mitral valve endocarditis having developed 78 days after double-lung transplantation for cystic fibrosis.

Antifungal Activity of Intraocularly Used Liquids against Aspergillus

The antifungal effectiveness of liquids used as intraocular tamponading agents in vitrectomy was tested against a strain of Aspergillus niger. This microorganism is a frequent causative factor of endophthalmitis. The strain belonged to the ATCC collection (A. niger ATCC 16404). The samples tested were: (a) perfluorocarbons: perfluorodecalin and perfluoroctane, (b) silicone oils: Siloil 1,000 and Siloil 5,000, and (c) balanced salt solutions: BSS and BSS Plus. The experiment consisted in inoculating the samples with the microorganism, in preserving the samples in 25 degrees C in the dark, and in taking small amounts of each product for counting surviving microorganisms at t = 0 and then after 1 day, and 1, 2, 3 and 4 weeks. Among the samples tested, perfluorocarbons and silicone oils conform to the standards. No increase, and in some samples decrease, in the number of microorganisms is observed during the second week, while the number drops to zero at the end of the experiment. Therefore, the use of these liquids is safe.