Record number:
658
Adverse Occurrence type:
MPHO Type:
Time to detection:
7 months
Alerting signals, symptoms, evidence of occurrence:
Donor: Resided for 2 years in French Guiana 20 years prior to death. Antibodies to histoplasmosis not detected. Recipient: 7 months post-txp, acute respiratory failure, severe dyspnea, unstable hemodynamics, grade 2 coma, jaundice, hypothermia (35.7 C) and anuria. CXR extensive miliary pneumopathy. Bronchoalveolar lavage fluid sample revealed numerous intracytoplasmic yeasts consistent with Histoplasma capsulatum morphology. Postmortem examination revealed disseminated histoplasmosis involving the lungs, digestive tract, spleen, adrenal glands and mesenteric lymph nodes. Cultures of biopsy specimens grew Histoplasma capsulatum.
Demonstration of imputability or root cause:
The authors considered it likely that Histoplasma capsulatum was present in the liver; however, retrospective examination of liver biopsy sections with methenamine silver staining did not reveal fungal elements.