Ann Thorac Surg 1991;52:107-111
© 1991 The Society of Thoracic Surgeons
Pneumocystis carinii pneumonia after heart transplantation
Hideaki Saigenji, MD1,
Mitsunori Kaneko, MD,
Birger Rhenmen, MD,
Richard J. Williams, MD,
M.Andre Vasu, MD,
Timothy B. Icenogle, MD,
Jack G. Copeland, MD*
Section of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Arizona, Tucson, Arizona USA
Accepted for publication March 20, 1991.
* Address reprint requests to Dr Copeland, Section of Cardiovascular and Thoracic Surgery, University of Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724.
Five patients with Pneumocystis carinii pneumonia after heart transplantation are reported. Four had severe clinical symptoms, whereas 1 was asymptomatic. Mechanical ventilatory support was necessary in 1 because of respiratory distress. Pneumocystis carinii infection developed in 4 patients within the first 4 postoperative months, and 1 patient had clinical disease 1 year after transplantation with a recurrence 9 months later. All were treated with trimethoprim-sulfamethoxazole either orally or intravenously (10 to 20 mg · kg–1 · day–1 of trimethoprim). All patients recovered from infection and received the same drug prophylactically for 2 to 20 months after the infection. All patients are doing well after Pneumocystis carinii infection except 1 who died after an acute myocardial infarction 4 years after infection. We conclude that trimethoprim-sulfamethoxazole is an effective agent for the treatment of Pneumocystis carinii pneumonia after heart transplantation.
1 Dr Saigenji's present address is The Second Department of Surgery, Kagoshima University Faculty of Medicine, 8-35-1 Sakuragaoka, Kagoshima 890, Japan.
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