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https://doi.org/10.15836/ccar2024.571

A rare infection following heart transplant: a case report

Katarina Grandavec orcid id orcid.org/0000-0002-6421-6471 ; Dubrava University Hospital, Zagreb, Croatia.
Biljana Hržić orcid id orcid.org/0000-0001-5441-0900 ; Dubrava University Hospital, Zagreb, Croatia.
Martina Vidak orcid id orcid.org/0009-0006-1973-8509 ; Dubrava University Hospital, Zagreb, Croatia.
Petra Kušenić orcid id orcid.org/0009-0008-8617-9932 ; Dubrava University Hospital, Zagreb, Croatia.
Magdalena Kunić orcid id orcid.org/0000-0001-7402-8135 ; Dubrava University Hospital, Zagreb, Croatia.
Ivica Benko orcid id orcid.org/0000-0002-1878-0880 ; Dubrava University Hospital, Zagreb, Croatia.


Puni tekst: engleski pdf 136 Kb

str. 571-571

preuzimanja: 101

citiraj

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Sažetak

Ključne riječi

heart transplantation; infection; abscess

Hrčak ID:

328582

URI

https://hrcak.srce.hr/328582

Datum izdavanja:

13.12.2024.

Posjeta: 296 *



Introduction: Heart transplantation is a complex procedure with a high risk of postoperative complications, including infections that are common due to immunosuppressive therapy. In addition to immediate complications such as bleeding and organ rejection, patients are also prone to long-term risks such as infections, hypertension, kidney failure, and even lymphoma. Infections can persist for up to 18 months after transplantation, requiring close nursing care. (1)

Case report: This case report presents a 40-year-old patient who underwent a heart transplant due to dilated cardiomyopathy caused by myocarditis and subsequently developed an infection in the form of an abscess in the right axilla, associated with the bacterium Bartonella henselae, the causative agent of cat scratch disease. The bacterium is transmitted through the scratch of an infected cat, causing lymph node inflammation. In immunocompromised patients, such as those with heart transplants, the infection can be serious, prolonging recovery and increasing the risk of complications such as bacillary angiomatosis or endocarditis, which could endanger the transplanted heart. Infection with Bartonella henselae is extremely rare in heart transplant patients. Research shows only one documented case, making this instance unique. Nursing care during the postoperative period of heart transplantation plays a crucial role in monitoring the patient’s condition, preventing complications, and ensuring recovery. The healthcare team must be diligent in managing immunosuppressive therapy to minimize the risk of heart rejection while adequately treating infections. With the cooperation of plastic surgeons, an incision of the abscess was performed, and antibiotics adjusted to the immunosuppressive therapy were administered. The patient was successfully discharged home without further complications.

Conclusion: This case underscores the importance of vigilant monitoring and infection management in heart transplant patients on immunosuppressive therapy. The rare Bartonella henselae infection highlights the unique risks faced by transplant recipients and the role of attentive nursing care in early detection and intervention. Collaborative, multidisciplinary care was essential in managing the infection and ensuring a successful recovery, emphasizing the need for tailored care approaches in transplant patient management.

LITERATURE

1 

Montoya JG, Giraldo LF, Efron B, Stinson EB, Gamberg P, Hunt S, et al. Infectious complications among 620 consecutive heart transplant patients at Stanford University Medical Center. Clin Infect Dis. 2001 September 1;33(5):629–40. https://doi.org/10.1086/322733 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/11486285


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