Donor-derived organ transplant transmission of coccidioidomycosis

Transpl Infect Dis. 2012 Jun;14(3):300-4. doi: 10.1111/j.1399-3062.2011.00696.x. Epub 2011 Dec 18.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antifungal Agents / therapeutic use*
  • Coccidioides / isolation & purification*
  • Coccidioidomycosis / diagnosis
  • Coccidioidomycosis / drug therapy
  • Coccidioidomycosis / transmission*
  • Fatal Outcome
  • Female
  • Fluconazole / therapeutic use
  • Fungemia / diagnosis
  • Fungemia / drug therapy
  • Fungemia / microbiology*
  • Humans
  • Immunosuppression / methods
  • Male
  • Middle Aged
  • Organ Transplantation / adverse effects*
  • T-Lymphocytes / immunology
  • Tissue Donors*
  • Tissue and Organ Harvesting
  • Travel
  • Young Adult

Substances

  • Antifungal Agents
  • Fluconazole