Simultaneous coccidioidomycosis and phaeohyphomycosis in a kidney transplant recipient: A case report and literature review

Transpl Infect Dis. 2020 Dec;22(6):e13365. doi: 10.1111/tid.13365. Epub 2020 Jun 25.


Advances in solid organ transplantation have improved the survival of end-stage organ disease at the expense of an increased risk for opportunistic infections. Unusual clinical presentations and the possibility of concurrent infections make diagnosing invasive fungal infection (IFI) more difficult. Here, we present a case of simultaneous vertebral infection caused by Coccidioides immitis-posadasii and subcutaneous phaeohyphomycosis due to Nigrograna mackinnonii in a kidney transplant recipient. The diagnosis of both infections required invasive procedures to obtain tissue and a high index of suspicion that more than one IFI could be present. A multidisciplinary team approach for the management of immunocompromised patients with suspected or diagnosed IFI is warranted.

Keywords: coccidioidomycosis; kidney transplant; phaeohyphomycosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antifungal Agents / therapeutic use
  • Ascomycota / isolation & purification
  • Biopsy / methods
  • Coccidioides / isolation & purification
  • Coccidioidomycosis / diagnosis*
  • Coccidioidomycosis / drug therapy
  • Coccidioidomycosis / microbiology
  • Coinfection / diagnosis*
  • Coinfection / drug therapy
  • Coinfection / microbiology*
  • Humans
  • Immunocompromised Host
  • Kidney Transplantation / adverse effects*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / microbiology
  • Phaeohyphomycosis / diagnosis*
  • Phaeohyphomycosis / drug therapy
  • Phaeohyphomycosis / microbiology
  • Polymerase Chain Reaction / methods
  • Treatment Outcome


  • Antifungal Agents

Supplementary concepts

  • Nigrograna mackinnonii