Subject(s)
Humans , Bacterial Infections/etiology , Cytomegalovirus Infections/etiology , Heart Transplantation/classification , Lung/pathology , Outpatient Clinics, Hospital/classification , Pneumocystis Infections/epidemiology , Pneumocystis Infections/etiology , Ceftriaxone/administration & dosage , Time Factors , Trimethoprim, Sulfamethoxazole Drug Combination/administration & dosageSubject(s)
Humans , Fever/complications , Fever/etiology , Heart Transplantation/classification , Heart Transplantation/rehabilitation , Pneumonia/diagnostic imaging , Chagas Disease/classification , Echocardiography , Infections/etiology , Pneumonia/drug therapy , Time Factors , Toxoplasmosis/prevention & controlSubject(s)
Humans , Lung/pathology , Heart Transplantation/rehabilitation , Creatine/urine , Sputum , Infections/blood , Radiography, Thoracic , Risk Factors , Time FactorsABSTRACT
PURPOSE--A prospective study of infective agents in diagnosed infections and deaths by specific agents in cardiac transplant patients. METHODS--Infections occurring in a series of 100 consecutive cardiac transplant patients after transplantation with definite infectious diagnosis were studied; follow-up after transplantation was 3 to 90 (medium 25.38 +/- 25.97) months. Diagnostic criteria for defining infections were those used in the Epidemiology and Quality Control Division of the INCOR, that are the same published by the Centers for Disease Control. The following parameters were analysed: infections/patient/time, causes of infection and organs infected, clinical presentation and clinical aspects of infections, methods used for the infective diagnosis and relationship between rejection episodes and infection. Death caused by infections and survival rates per infection were also studied. RESULTS--Bacterial infections were more frequent (56.3 of all infections), followed by viral infections (19.6), fungal infections (18) and protozoal infections (6.1). Of all deaths after transplantation, 25 were caused by infections. CONCLUSION--Infections are an important cause of mortality and morbidity in this patient population; our data are in accordance to the other reported series.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Infections/etiology , Heart Transplantation/adverse effects , Prospective Studies , Actuarial AnalysisABSTRACT
De janeiro de 1988 a janeiro de 1989 todos os pacients submetidos a transplante de coraçiao de medula óssea no Instituto do Coraçäo do Hospital das Clínicas da Faculdade de Medicina da Universidade de Siao Paulo foram estudados quanto à incidência e morbidade das infecçöes pós-transplante causadas por vírus do grupo herpes. Cinco recipientes de medula óssea e 5 transplantados cardíacos foram observados por um período médio de 4.2 meses após o transplante. Todos os pacientes tinham sorologia positiva para citomegalovírus (CMV) antes do transplantee 80% desenvolveram uma ou mais recorrências durante o período de observaçäo. Dos 12 episódios de infecçäo por CMV detectados neste estudo, 83% foram acompanhados por alteraçöes clínicas ou laboratoriais. Apenas um caso apresentou doença grave. A incidência de infecçöes causadas por vírus Herpes simplex (HSV) fossem reprsentadas por lesöes orais ou genitais, houve também umcaso de hepatite por HSV. Um dos 6 episódios de infecçäo, por HSV. Um dos 6 episódios de infecçäo, por HSV que foram tratados com aciclovir näo respondeu ao tratamento. Posteriormente, o paciente se beneficiou com o uso de ganciclovir. Todos os indivíduos apresentavam antes do transplante anticorpos anti-vírus da varicela zoster. Porém, näo houve nenhum caso de reativaçäo. Este estudo realça a importância do cocntrole diagnóstico ativo da infeccöes por herpes-vírus em pacientes transplantados. Tanto as infecçöes causadas por CMV como por HSV mostraram alta incidência e grande mortalidade indicando a necessidade de quimioprofilaxia