Donor‐derived organ transplant transmission of coccidioidomycosis

• Published in: Transplant infectious disease Vol. 14; no. 3; pp. 300 - 304
• Main Authors: Dierberg, K.L., Marr, K.A., Subramanian, A., Nace, H., Desai, N., Locke, J.E., Zhang, S., Diaz, J., Chamberlain, C., Neofytos, D.
• Format: Journal Article
• Language: English
• Published: Denmark 01.06.2012
• Subjects: Adolescent; Antifungal Agents - therapeutic use; Coccidioides - isolation & purification; coccidioidomycosis; Coccidioidomycosis - diagnosis; Coccidioidomycosis - drug therapy; Coccidioidomycosis - transmission; Fatal Outcome; Female; Fluconazole - therapeutic use; fungal infection; Fungemia - diagnosis; Fungemia - drug therapy; Fungemia - microbiology; Humans; Immunosuppression - methods; Male; Middle Aged; Organ Transplantation - adverse effects; solid organ transplantation; T-Lymphocytes - immunology; Tissue and Organ Harvesting; Tissue Donors; transmission; Travel; Young Adult
• ISSN: 1398-2273; 1399-3062
• DOI: 10.1111/j.1399-3062.2011.00696.x

: 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.