Fungal infection in the lung transplant recipient

The incidence of fungal infections in lung transplant (LT) recipients is reported to be between 10% and 35%. This is significantly higher than the incidence of fungal infections in other solid-organ transplant recipients. Although both opportunistic and endemic fungal infections may be encountered after lung transplantation, Aspergillus and Candida are the most common organisms. The spectrum of Aspergillus infection includes Aspergillus tracheobronchitis, invasive Aspergillus, aspergilloma, and bronchiolitis obliterans with organizing pneumonia in association with Aspergillus pneumonia. Aggressive therapy including the use of amphotericin, liposomal amphotericin, 5-fluorocytosine, azoles, and surgery may be required to successfully treat fungal infections in LT patients. This article reviews the presentation, diagnosis, and therapy of fungal infections in LT recipients.