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Adverse Occurrence type:
Very unusual. To our knowledge, this is the first case published of microsporidial transmission
Time to detection:
7- 10 weeks
Alerting signals, symptoms, evidence of occurrence:
Fever, malaise, myalgias and fatigue were present in both kidney recipients. The lung recipient started with fever and altered mental status. One of the kidney recipients was diagnosed by kidney biopsy. Subsequently, the other kidney and the lung were diagnosed by demonstrating the microorganism in urine samples by culture, IFA and NAT.
Demonstration of imputability or root cause:
A recovered plasma sample from the donor was analyzed and tested positive by serology for microsporidia.
Microsporidiosis Acquired Through Solid Organ Transplantation: A Public Health Investigation. Hocevar SN et al.Ann Intern Med. 2014 Feb 18;160(4):213-20.
Cluster of febrile illness among 3 solid organ transplant recipients from a common donor. Two kidneys and a bilateral lung.--> record cloned for kidney and lung (EP) I cannot assign adverse occurrence type as fungal because microsporidiasis is not an option.--> ok added (EP)
Expert comments for publication:
Microsporidia infection has been reported in solid organ transplantation. However, the donor as a source was never studied. In this communication, three recipients from the same donor developed the same illness in the same time frame. Unfortunately, donor can carry microsporidia completely asymptomatic which make it very difficult to suspect and detect. Another question that raises from this case is the necessity of an autopsy for every donor to rule out as many potential harms as possible that could be transmitted to the recipient.