Abstract
IntroductionAspergillus spp. infections mainly affect patients who are immunocompromised, and are extremely rare in immunocompetent individuals.Case presentationAspergillus post-operative mediastinitis is considered to be a devastating infection, usually affecting patients undergoing cardiothoracic surgery with specific predisposing factors. We describe the case of an immunocompetent 68-year-old Caucasian man with severe chronic thromboembolic pulmonary hypertension, who underwent pulmonary thromboendarterectomy and developed post-operative mediastinitis due to Aspergillus flavus. The environmental control did not reveal the source of A. flavus infection and, despite combined antifungal therapy, our patient died as a result of septic shock and multiple organ failure.ConclusionAspergillus mediastinitis mainly affects patients after cardiosurgery operations with predisposing factors, and it is unusual in patients who are immunocompetent. The identification of the Aspergillus spp. source is often difficult, and there are no guidelines for the administration of pre-emptive therapy in this population of at-risk patients.
Highlights
Aspergillus spp. infections mainly affect patients who are immunocompromised, and are extremely rare in immunocompetent individuals.Case presentation: Aspergillus post-operative mediastinitis is considered to be a devastating infection, usually affecting patients undergoing cardiothoracic surgery with specific predisposing factors
Aspergillus mediastinitis mainly affects patients after cardiosurgery operations with predisposing factors, and it is unusual in patients who are immunocompetent
The identification of the Aspergillus spp. source is often difficult, and there are no guidelines for the administration of pre-emptive therapy in this population of atrisk patients
Summary
Aspergillus mediastinitis mainly affects patients undergoing cardiosurgery operations with predisposing factors, and is unusual in patients who are immunocompetent. Our patient could be added to the series of Pasqualotto and Denning as a third immunocompetent patient with postoperative Aspergillus spp. mediastinitis [1]. Author details 1Second Department of Critical Care Medicine, ‘ATTIKON’ University Hospital, University of Athens Medical School, Athens Greece. Doi:10.1186/1752-1947-4-312 Cite this article as: Dimopoulos et al.: Post-operative Aspergillus mediastinitis in a man who was immunocompetent: a case report.
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