RESUMEN
Infections produced by Mycobacterium abscessus are emerging in immunosuppressed patients, such as solid organ transplant recipients. We report the first case, to our knowledge, of a vertebral osteomyelitis caused by M. abscessus in a heart transplant recipient, and review the risk factors, manifestations, and therapeutic approaches to this uncommon disease.
Asunto(s)
Trasplante de Corazón/efectos adversos , Mycobacterium/aislamiento & purificación , Osteomielitis/complicaciones , Infecciones del Sistema Respiratorio/complicaciones , Anciano , Antibacterianos/uso terapéutico , Claritromicina/uso terapéutico , Femenino , Humanos , Huésped Inmunocomprometido , Mycobacterium/clasificación , Osteomielitis/diagnóstico por imagen , Osteomielitis/tratamiento farmacológico , Osteomielitis/microbiología , Infecciones del Sistema Respiratorio/diagnóstico por imagen , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/microbiología , Factores de Riesgo , Resultado del TratamientoAsunto(s)
Candidiasis/diagnóstico , Trasplante de Corazón , Derrame Pericárdico/diagnóstico , Pericarditis Constrictiva/diagnóstico , Complicaciones Posoperatorias/diagnóstico , Candidiasis/etiología , Humanos , Masculino , Persona de Mediana Edad , Derrame Pericárdico/etiología , Pericarditis Constrictiva/etiología , Complicaciones Posoperatorias/etiologíaRESUMEN
UNLABELLED: Inherited myopathies in patients with secondary end-stage cardiomyopathies have always been considered a relative contraindication for cardiac transplantation. High operative risk related to muscle impairment and potential graft involvement secondary to the underlying myopathy have been the two main reasons implicated in the poor prognosis. OBJECTIVE: The aim of this study was to evaluate the outcome in patients who underwent cardiac transplantation in our hospital due to end-stage cardiomyopathy secondary to inherited myopathies. METHODS: Among 311 patients who underwent heart transplantation in our hospital, five (2%) had end-stage cardiomyopathies related to inherited myopathies. Four patients had muscular dystrophy (three Becker's muscular dystrophy and one hips-dystrophy) and the fifth desminopathy. In one patient cardiomyopathy was the initial manifestation of the disease. Mean age at the time of transplantation was 38.6 years (range from 24 to 55). The mean follow-up after transplantation was 57.4 months (range from 13 to 128). The intraoperative and postoperative course of these individuals did not show higher complication rates than other patients. All recipients experienced successful rehabilitation; no evidence of graft dysfunction has been detected during follow-up. All of them are alive with a good performance status. CONCLUSIONS: In our experience, patients who underwent heart transplantation due to end-stage cardiomyopathy secondary to inherited myopathy with only a mild degree of muscle impairment did not display higher postoperative nor long-term complications compared to other recipients.