Approach to the Solid Organ Transplant Patient with Suspected Fungal Infection

Judith A Anesi; John W Baddley

doi:10.1016/j.idc.2015.10.001

Approach to the Solid Organ Transplant Patient with Suspected Fungal Infection

Infect Dis Clin North Am. 2016 Mar;30(1):277-96. doi: 10.1016/j.idc.2015.10.001. Epub 2015 Dec 28.

Authors

Judith A Anesi¹, John W Baddley²

Affiliations

¹ Division of Infectious Diseases, University of Pennsylvania, 3400 Spruce Street, 3 Silverstein, Suite E, Philadelphia, PA 19104, USA.
² Department of Medicine, University of Alabama at Birmingham, 1900 University Boulevard, 229 THT, Birmingham, AL 35294, USA; Medical Service, Birmingham VA Medical Center, 700 South 19th street, Birmingham, AL 35233, USA. Electronic address: jbaddley@uab.edu.

Abstract

In solid organ transplant (SOT) recipients, invasive fungal infections (IFIs) are associated with significant morbidity and mortality. Detection of IFIs can be difficult because the signs and symptoms are similar to those of viral or bacterial infections, and diagnostic techniques have limited sensitivity and specificity. Clinicians must rely on knowledge of the patient's risk factors for fungal infection to make a diagnosis. The authors describe their approach to the SOT recipient with suspected fungal infection. The epidemiology of IFIs in the SOT population is reviewed, and a syndromic approach to suspected IFI in SOT recipients is described.

Keywords: Aspergillus; Candida; Cryptococcus; Endemic fungi; Invasive fungal infection; Mold; Solid organ transplant.

Publication types

Review

MeSH terms

Antifungal Agents / therapeutic use
Humans
Immunocompromised Host*
Mycoses / diagnosis*
Mycoses / immunology*
Mycoses / microbiology
Organ Transplantation / adverse effects*

Substances

Antifungal Agents

Grants and funding

T32 AI055435/AI/NIAID NIH HHS/United States