cefamandole and Cytomegalovirus-Infections

Infectious complications were studied in 14 patients who received heart-lung transplants at Stanford University Medical Center from March 1981 to November 1983. Twenty-nine infections occurred in 12 patients: 18 bacterial, nine viral, and two fungal. Sixteen (89 percent) of the bacterial infections occurred in the lung. Because of frequent colonization of the lower respiratory tract, the specificity of transtracheal aspiration and bronchoscopy was low. Empiric broad-spectrum antibiotic therapy was usually successful, and no patient died of bacterial infection. Cytomegalovirus infection occurred in six and herpes simplex virus infection in three patients. Two patients had invasive candidiasis at postmortem examination. This series emphasizes the importance of infection, particularly of the lung, in causing morbidity and mortality in heart-lung transplant recipients.

Topics: Adult; Antilymphocyte Serum; Bacterial Infections; Candidiasis; Cefamandole; Cyclosporins; Cytomegalovirus Infections; Female; Graft Rejection; Heart Transplantation; Heart-Lung Transplantation; Herpes Simplex; Humans; Lung Transplantation; Male; Methylprednisolone; Middle Aged; Pneumonia; Postoperative Care; Postoperative Complications; Premedication; T-Lymphocytes

Cardiopulmonary resuscitation was successful in a healthy 29-year-old woman who had been submerged for 20 minutes in water at 10 degrees C. The evolution was characterized by the development of a multifactorial ARDS (secondary drowning) and sepsis caused by Aeromonas hydrophila and Acinetobacter anitratum. Fibrosing alveolitis caused a restrictive syndrome with severe mechanical impairment and transitory therapy-resistant hypoxemia. It is suggested that prolonged submersion in cold water is also a treatable and completely reversible condition in adults. In our patient without neurological sequelae the pulmonary function studies after 3 months show complete recovery from the mechanical impairment. After a follow-up period of 11 months only mild abnormalities of gas exchange persist.

Topics: Adult; Cefamandole; Cold Temperature; Cytomegalovirus Infections; Drowning; Female; Humans; Hypoxia; Lung; Pneumonia; Positive-Pressure Respiration; Pulmonary Edema; Pulmonary Fibrosis; Radiography; Resuscitation; Tobramycin; Transfusion Reaction