[Infections caused by virus in 100 patients submitted to heart transplantation]. / Infecções causadas por vírus em 100 pacientes submetidos a transplante cardíaco.

PURPOSE: To analyse prevalence, clinical features and organ involvement in viral infections occuring after heart transplantation. METHODS: One hundred consecutive heart transplantation patients were studied. The follow-up was three to 90 (mean 23.32 +/- 25.97) months. Viral infections were diagnosed using the Center for Disease Control criteria. RESULTS: Viral infections were responsible for 51 infections, 19.6% of all infections in this patient population. Herpesvirus infection was the most common etiology: 32 (59.25%) of all viral infections were caused by reactivation of or reinfection by cytomegalovirus. Of those infections 27 (84.37%) occurred in the first three weeks following surgery. Only 4 (12.50%) of those showed clinical signs of cytomegalovirus disease. Other herpesvirus causing infections were herpes simplex and varicella-zoster virus. CONCLUSION: Infections are common after heart transplantation and viral infections of herpesviridae family are important causes of those infections; usually as reactivation in an immune suppressed patient. The most important viral infections were caused by reactivation of or reinfection by cytomegalovirus.

[Bacterial infections in 100 patients submitted to heart transplantation]. / Infecções bacterianas em 100 pacientes submetidos a transplante cardíaco.

PURPOSE: To evaluate clinical findings and etiology of bacterial infections diagnosed in 100 consecutive heart transplantations. METHODS: One hundred consecutive heart transplant patients were studied. Follow-up after heart transplantation varied from 3 to 90 (mean 25.38 +/- SD 25.97) months. Etiology of bacterial infection was established using the Centers for Disease Control criteria. RESULTS: Bacterial infection was the most common cause of infection after heart transplantation; diagnosis was difficult. Infection sites were skin, mucous, membranes, soft tissue, surgical scar, pericardial and pleural spaces, soft tissue around heart pacing devices, urinary tract; bacteremias and endocarditis were also found. All bacterial agents recovered were fully identified. CONCLUSION: Bacterial infections are the most common infections in the first month after heart transplantation. They are important and also common after the treatment of the rejection episodes. Rapid diagnosis and adequate treatment are essential to prevent morbidity and death.

[Fungal infections in 100 patients subjected to heart transplantation]. / Infecções fúngicas em 100 pacientes submetidos a transplante cardíaco.

PURPOSE: To evaluate prevalence, causes, clinical aspects, topography and deaths due to fungal infections diagnosed in a series of patients submitted to heart transplantation. METHODS: 100 consecutive patients submitted to heart transplantation were studied. Follow-up was three to 90 (mean 25.38 +/- 25.97) months. Fungal infections were diagnosed by the Centers for Disease Control criteria. RESULTS: Forty seven fungal infections were found, with three deaths caused mainly by fungal infection. The most common infection in this series was oral infection by Candida albicans, Acremonium sp, Aspergillus sp, Candida tropicalis, Histoplasma capsulatum and Pneumocystis carinii were also responsible for infections in this patient population. CONCLUSION: Fungal infections caused three deaths in this series, and were responsible for increased morbidity. The authors suggest prophylactic and therapeutic recommendations.