Donor-derived organ transplant transmission of coccidioidomycosis.

TitleDonor-derived organ transplant transmission of coccidioidomycosis.
Publication TypeJournal Article
Year of Publication2012
AuthorsDierberg KL, Marr KA, Subramanian A, Nace H, Desai N, Locke JE, Zhang S, Diaz J, Chamberlain C, Neofytos D
JournalTransplant infectious disease : an official journal of the Transplantation Society// Transpl Infect Dis
Pagination300 - 4
Date Published2012//
ISBN Number1399-3062
Other Numbersd1d, 100883688
Keywords*Antifungal Agents/tu [Therapeutic Use], *Coccidioides/ip [Isolation & Purification], *Coccidioidomycosis/tm [Transmission], *Fungemia/mi [Microbiology], *Organ Transplantation/ae [Adverse Effects], *Tissue Donors, Adolescent, Coccidioidomycosis/di [Diagnosis], Coccidioidomycosis/dt [Drug Therapy], Fatal Outcome, Female, Fluconazole/tu [Therapeutic Use], Fungemia/di [Diagnosis], Fungemia/dt [Drug Therapy], Humans, Immunosuppression/mt [Methods], Male, Middle Aged, T-Lymphocytes/im [Immunology], Tissue and Organ Harvesting, Travel, Young Adult

Coccidioidomycosis in solid organ transplant recipients most often occurs as a result of primary infection or reactivation of latent infection. Herein, we report a series of cases of transplant-related transmission of coccidioidomycosis from a single donor from a non-endemic region whose organs were transplanted to 5 different recipients. In all, 3 of the 5 recipients developed evidence of Coccidioides infection, 2 of whom had disseminated disease. The degree of T-cell immunosuppression and timing of antifungal therapy initiation likely contributed to development of disease and disease severity in these recipients. This case series highlights the importance of having a high index of suspicion for Coccidioides infection in solid organ transplant recipients, even if the donor does not have known exposure, given the difficulties of obtaining a detailed and accurate travel history from next-of-kin.Copyright © 2011 John Wiley & Sons A/S.

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