ABSTRACT
Invasive fungal infection (IFI) is a serious complication of lung transplantation and is associated with significant morbidity and mortality. When compared with other solid-organ transplant (SOT) recipients, lung transplant recipients are more susceptible to fungal infection. This increased susceptibility to fungal infection stems from continuous and direct contact with the environment, profound immunosuppression, and impaired clearance mechanisms caused by allograft denervation and colonization of the airways by organisms from the upper respiratory tract or native lung in the case of single-lung transplantation. 1 In this setting, infection can occur as a result of contamination from the allograft or the recipient’s airway flora and reactivation of a previously acquired latent infection and primary posttransplant infection. The cumulative incidence of IFI in the first year after lung transplantation is approximately 8.6%. 2 Molds account for 70% of IFI after lung transplantation, with Aspergillus being the most frequent pathogen. 3 Although observed less frequently, non-Aspergillus molds such as Scedosporium and Fusarium, dematiaceous fungi, fungi of the class Zygomycetes, and various fungi responsible for endemic mycoses are increasingly recognized as emerging pathogens in this population. Yeast infection occurs less frequently than mold infection and mainly involves Candida and Cryptococcus species.
