Here we report the seven-year long-term survival after Aspergillus
fumigatus mediastinitis after heart transplantation, an uncommonly
described condition. A 66-year-old male developed infection with A.
fumigatus covering the entire thoracic cavity with a fungal turf after
orthotopic heart transplantation. Repeated surgical removal of
infectious and necrotic tissue together with innovative topical
treatment using voriconazole and chlorhexidine combined with systemic
antifungal treatment lead to control of infection. Definitive wound
closure was achieved by standard sternal refixation and latissimus dorsi
muscle flap plasty. Survival after A. fumigatus mediastinitis after
heart transplantation was achieved with sequential debridement in
combination with topical application of antifungal agents.