Clinical Presentation

Pneumonia complicating heart transplantation presents as persistent respiratory failure and inability to wean from mechanical ventilation. In addition, fever may be present, and respiratory secretions are purulent. Radiographic findings that demonstrate consolidative changes aide in the diagnosis and follow-up of patients. Respiratory tract cultures are collected routinely in all mechanically-ventilated patients to determine optimal antimicrobial therapy in the event of an established infection.

Mediastinitis is a serious complication of heart transplantation, presenting as fever, leukocytosis, and signs of systemic toxicity. CT imaging establishes the diagnosis and extent of the infection.

Sternal wound infections may present early in the post-transplantation course as poor healing or dehiscence of the wound or later in the transplant course with sinus tract formation and purulent discharge. CT or nuclear medicine imaging studies may help in defining this infectious process.

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