Invasive aspergillosis in liver transplant recipients: association with candidemia and consumption coagulopathy and failure of prophylaxis with low-dose amphotericin B

Clin Infect Dis. 1993 Nov;17(5):906-8. doi: 10.1093/clinids/17.5.906.

Abstract

Invasive aspergillosis developed in three (5%) of 55 adult liver transplant recipients at our institution. All three of our patients had concomitant candidemia and consumption coagulopathy, and invasive aspergillosis developed while they were receiving therapy with intravenous amphotericin B (0.5 mg/[kg.d]). The simultaneous occurrence of candidemia and invasive aspergillosis in liver transplant recipients may reflect a common defect in the host-defense mechanism against Candida and Aspergillus organisms (i.e., impaired phagocytic and mononuclear macrophage function) and liver disease per se. These three cases suggest that such low-dose intravenous amphotericin B will likely be ineffective if used as antifungal prophylaxis for invasive aspergillosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amphotericin B / administration & dosage
  • Amphotericin B / pharmacology
  • Aspergillosis / etiology*
  • Aspergillosis / prevention & control
  • Candidiasis / etiology
  • Disseminated Intravascular Coagulation / etiology
  • Fungemia / etiology
  • Humans
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged

Substances

  • Amphotericin B