# Letter to the Editor: Cavitary Pulmonary Aspergillosis in Heart Transplantation Recipient

## Authors

- Chao-Kun Chen ([ORCID](https://orcid.org/0009-0001-4380-5680)) — Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan
- Chien-Ming Chao ([ORCID](https://orcid.org/0000-0003-0235-9060)) — Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan

## Article information

- **Journal:** The Ulutas Medical Journal (Ulutas Med J), ISSN 2149-388X
- **Issue:** Volume 10, Issue 3 (2024), pages 51–52
- **Article type:** Letter to the Editor
- **Published online:** 2024-09-16
- **DOI:** [10.5455/umj.20240715063204](https://doi.org/10.5455/umj.20240715063204)
- **Licence:** [CC BY-NC 4.0](https://creativecommons.org/licenses/by-nc/4.0/)
- **Article page:** https://www.ulutasmedicaljournal.com/?mno=209909
- **PDF:** https://www.ulutasmedicaljournal.com/pdf/209909.pdf

## Abstract

A 53-year-old male, a heart transplantation recipient for dilated cardiomyopathy under immunosuppressants and with a history of diabetes mellitus, presented with a productive cough and chest pain for days. Additionally, he had a low-grade fever and progressive dyspnea. Chest imaging revealed multiple cavitary lesions, the largest being 8.8 x 6.4 cm over the left upper lobe (Figure 1A, arrows), indicative of fungal infections. Microbiological analysis detected Aspergillus fumigatus in sputum, alongside elevated galactomannan optical density index levels in bronchoalveolar fluid (18) and serum (3.7). Voriconazole was administered, and surgical resection of the large cavity (Figure 1B) was performed, confirming cavitary pulmonary aspergillosis upon histopathological examination. Despite antifungal therapy, the patient's condition deteriorated, resulting in death two weeks later. This case highlights the challenging management of cavitary pulmonary aspergillosis in immunocompromised patients, particularly in the context of heart transplantation and diabetes mellitus. Despite aggressive antifungal therapy and surgical intervention, the poor prognosis underscores the need for early detection and targeted treatment strategies in complex clinical scenarios.

## Keywords

Cavitary Pulmonary Aspergillosis; Heart Transplantation; Case report

## How to cite

Chen CK, Chao CM. Letter to the Editor: Cavitary Pulmonary Aspergillosis in Heart Transplantation Recipient. Ulutas Med J. 2024;10(3):51-52. doi:10.5455/umj.20240715063204

## References

1. Klein J, Rello J, Dimopoulos G, Bulpa P, Blot K et al. Invasive pulmonary aspergillosis in solid-organ transplant patients in the intensive care unit. Transpl Infect Dis 2022;24(1):e13746 https://doi.org/10.1111/tid.13746
2. Machado M, Fortún J, Muñoz P. Invasive aspergillosis: A comprehensive review. Med Clin (Barc). 2024;163(4):189-198 https://doi.org/10.1016/j.medcli.2024.01.045
3. Chao CM, Lai CC, Chan KS, Yang CC, Chen CM, Ho CH, et al. Characteristics and outcomes for pulmonary aspergillosis in critically ill patients without influenza: A 3-year retrospective study. J Infect Public Health 2023; 16(12):2001-9 Author’s Details Chao-Kun Chen: Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan https://doi.org/10.1016/j.jiph.2023.09.016