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Published on: May 7, 2015
Transplant-associated Ochroconis gallopava infections
S Shoham1, L Pic-Aluas, J Taylor
1Section of Infectious Diseases, Washington Hospital Center, Washington, District of Columbia 20010, USA. Shmuel.Shoham@medstar.net
Background:
Ochroconis gallopava is a neurotropic dematiaceous mold that causes respiratory and central nervous system (CNS) infection in domestic poultry and in immunocompromised patients. We recently treated 3 solid organ transplant (SOT) recipients for pulmonary Ochroconis infections with successful outcome, prompting us to review the literature on this unique pathogen.
Methods:
We reviewed all published cases of O. gallopava infections in SOT recipients and analyzed the impact of CNS infection on the outcome.
Results:
In addition to the 3 new cases reported here, 9 published cases of Ochroconis infection were analyzed. The disease involved the lungs only in 5/12 (42%) of patients, brain in 6/12 (50%) patients, and lung and skin in 1 patient. Survival was significantly reduced with brain infection (33% vs. 100%; P<0.03; Fisher's exact test).
Conclusions:
O. gallopava may infect SOT recipients with a particular tropism for the CNS. Early recognition of O. gallopava pulmonary infection is important, as the prognosis is excellent before dissemination to the brain.
Insights
Ochroconis gallopava infections in solid organ transplant recipients can affect the lungs or brain. Early lung infection treatment is crucial, as brain involvement significantly reduces survival rates.
Area of Science:
- Mycology
- Infectious Diseases
- Transplant Medicine
Background:
- Ochroconis gallopava is a neurotropic mold causing respiratory and central nervous system (CNS) infections in poultry and immunocompromised individuals.
- Three recent solid organ transplant (SOT) recipients with pulmonary Ochroconis infections were successfully treated.
- This prompted a review of O. gallopava infections in SOT recipients.
Purpose of the Study:
- To review published cases of Ochroconis gallopava infections in SOT recipients.
- To analyze the impact of CNS infection on patient outcomes.
Main Methods:
- Systematic literature review of O. gallopava infections in SOT recipients.
- Analysis of clinical data, including site of infection and patient outcomes.
- Statistical analysis to determine the impact of CNS involvement on survival.
Main Results:
- A total of 12 cases (3 new, 9 published) were analyzed.
- Pulmonary infection occurred in 42% of patients, CNS infection in 50%, and combined lung/skin in 1 patient.
- Survival was significantly lower in patients with brain infection (33%) compared to those without (100%; P<0.03).
Conclusions:
- Ochroconis gallopava exhibits a tropism for the CNS in SOT recipients.
- Early recognition and treatment of pulmonary O. gallopava infections are vital.
- Prognosis is excellent if infection is treated before CNS dissemination.
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