Journal Article

Pneumonia After Heart Transplantation: A Multiinstitutional Study

J. M. Cisneros, P. Muñoz, J. Torre Cisneros, M. Gurgui, Ma. J. Rodriguez Hernandez, J. Ma. Aguado and A. Echaniz

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 2, pages 324-331
Published in print August 1998 | ISSN: 1058-4838
Published online August 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514649
Pneumonia After Heart Transplantation: A Multiinstitutional Study

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A multiinstitutional study of 307 heart transplant recipients was carried out to determine the clinical, radiographic, and prognostic characteristics, the incidence, and the etiology of pneumonias in the first year after transplantation. There were 21.1 cases of pneumonia per 100 heart transplantations. Seventy-five percent of the cases occurred in the first trimester. Eighty-two causal agents were identified, of which 60% were opportunistic, 25% were nosocomial, and 15% were community-acquired. The most frequent isolates were cytomegalovirus (20), Aspergillus species (13), and Pneumocystis carinii (11). Hemoptysis occurred more frequently in aspergillus pneumonias than in other pneumonias (54% vs. 6%, respectively; P < .05); aspergillus pneumonia was the only type of pneumonia during which cavitated nodules were noted on thoracic radiographs. The overall mortality rate was 30.8%; the independent factors of a poor prognosis were aspergillus infection (relative risk [RR], 7.4; 95% confidence interval [CI], 5.8–9.1) and bilateral pulmonary infiltrates (RR, 10; 95% CI, 8.5–11.4).

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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