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Ann Thorac Surg 1991;52:107-111
© 1991 The Society of Thoracic Surgeons


Articles

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.


    Abstract
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 Abstract
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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.


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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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  1. Kaye MP. The registry report. Eighth Annual Meeting of the International Society for Heart Transplantation. Los Angeles . 1988.
  2. Copeland JG, Mammana RB, Fuller JK, et al. Heart transplantation: four years' experience with conventional immunosup-pression JAMA 1984;251:1563-1566.[Medline]
  3. Copeland JG, Emery RW, Levinson MM, et al. Cyclosporine: an immunosuppressive panacea? J Thorac Cardiovasc Surg 1986;91:26-39.[Abstract]
  4. Young LS. Clinical aspects of pneumocystosis in man: epidemiology, clinical manifestations, diagnostic approaches, and sequelaeIn: Young LS, editor. Pneumocystis carinii pneumonia. New York: Marcel Dekker; 1984. pp. 139-174.
  5. Copeland JG. Cardiac transplantation Curr Probl Cardiol 1988;13:157.
  6. Baumgartner WA. Infection in cardiac transplantation Heart Transplant 1983;3:75-80.
  7. Schafers HJ, Cremer J, Wahlers T, et al. Pneumocystis carinii pneumonia following heart transplantation Eur J Cardiothorac Surg 1987;1:49-52.[Abstract/Free Full Text]
  8. Jamieson SW, Oyer PE, Reitz BA, et al. Cardiac transplantation at Stanford Heart Transplant 1981;1:86-91.
  9. Mammana RB, Petersen EA, Fuller JK, et al. Pulmonary infections in cardiac transplant patients: modes of diagnosis, complications, and effectiveness of therapy Ann Thorac Surg 1983;36:700-705.[Abstract/Free Full Text]
  10. Oyer PE, Stinson EB, Bieber CP, Shumway NE. Cardiac transplantationIn: Chatterjee SN, editor. Organ transplantation. Boston: PSG; 1982. pp. 347-368.
  11. Icenogle TB, Copeland JG. Emergency evaluation of the acutely ill heart transplant patient2nd ed. Boswell Hosp Proc. 13. 1987. pp. 10-16.
  12. Ruskin J. Parasitic diseases in the compromised hostIn: Rubin RH, Young LS, editors. Clinical approach to infection in the compromised host. 2nd ed. New York: Plenum; 1988. pp. 253-304.
  13. Lau WK, Young LS, Remington JS. Pneumocystis carinii pneumonia: diagnosis by examination of pulmonary secretions JAMA 1976;236:2399-2402.[Medline]
  14. DeVivo F, Pond GD, Rhenman B, et al. Transtracheal aspiration and fine needle aspiration biopsy for the diagnosis of pulmonary infection in heart transplant patients J Thorac Cardiovasc Surg 1988;96:696-699.[Abstract]
  15. Pitchenik AE, Ganjei P, Torres A, et al. Sputum examination for the diagnosis of Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome Am Rev Respir Dis 1986;133:226-229.[Medline]
  16. Hartman B, Koss M, Hui A, et al. Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome (AIDS): diagnosis with bronchial brushings, biopsy, and bronchoalveolar lavage Chest 1985;87:603-607.[Medline]
  17. Scheinhorn DJ, Joyner LR, Whitcomb ME. Transbronchial forceps lung biopsy through the fiberoptic bronchoscope in pneumocystis carinii pneumonia Chest 1974;66:294-295.[Medline]
  18. Ognibene FP, Shelhamer J, Gill V, et al. The diagnosis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome using subsegmental bronchoalveolar lavage Am Rev Respir Dis 1984;129:929-932.[Medline]
  19. Peters SG, Prakash UBS. Pneumocystis carinii pneumonia: review of 53 cases Am J Med 1987;82:73-78.[Medline]
  20. Kovacs JA, Ng VL, Masur H, et al. Diagnosis of Pneumocystis carinii pneumonia: improved detection in sputum with use of monoclonal antibodies N Engl J Med 1988;318:589-593.[Medline]
  21. Doppman JL, Geelhoed GW, de Vita VT. Atypical radiographic feature in Pneumocystis carinii pneumonia Radiology 1975;114:39-44.[Abstract/Free Full Text]
  22. Israel HL, Gottlieb JE, Schulman ES. Hypoxemia with normal chest roentgenogram due to Pneumocystis carinii pneumonia. Diagnostic errors due to low suspicion of AIDS Chest 1987;92:857-859.[Medline]
  23. Winston DJ, Lau WK, Gale RP, Young LS. Trimethoprim-sulfamethoxazole for the treatment of Pneumocystis carinii pneumonia Ann Intern Med 1980;92:762-769.[Medline]




This Article
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Right arrow Articles by Saigenji, H.
Right arrow Articles by Copeland, J. G.