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Transmission of Cryptococcus neoformans by Organ Transplantation

John W Baddley1, Denise C Schain, Asmita A Gupte

  • 1Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. jbaddley@uab.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 12, 2011
PubMed
Abstract

Insights

Solid organ transplantation can transmit Cryptococcus neoformans. Donor evaluation for cryptococcosis is crucial, especially with unexplained neurologic symptoms, to prevent recipient infections.

Area of Science:

  • Infectious Diseases
  • Transplantation Medicine
  • Mycology

Background:

  • Cryptococcus neoformans is an opportunistic fungal pathogen.
  • Solid organ transplantation (SOT) is a potential route for pathogen transmission.
  • Donor-derived infections pose a significant risk to transplant recipients.

Observation:

  • Three recipients of organs from a single donor developed cryptococcosis.
  • The donor presented with undiagnosed neurologic symptoms and was found to have cryptococcal meningoencephalitis post-mortem.
  • Recipients developed varied clinical manifestations including cryptococcemia, pneumonia, and meningitis.

Findings:

  • Molecular genotyping (multilocus sequence typing) confirmed identical Cryptococcus neoformans strains in all three recipients.
  • This provides definitive evidence of transmission from the donor.
  • Two of the three recipients recovered after extended antifungal treatment.

Implications:

  • Highlights the importance of screening SOT donors for Cryptococcus, particularly those with neurological conditions.
  • Suggests that early diagnosis and treatment in donors could prevent post-transplant infections.
  • Underscores the need for vigilance in diagnosing fungal infections in transplant recipients.

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