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Donor-derived Coccidioides immitis fungemia in solid organ transplant recipients

E Blodget1, P Jan Geiseler, R A Larsen

  • 1Division of Infectious Diseases, Department of Medicine, University of Southern California Keck School of Medicine, Los Angeles, California 90033, USA. eblodget@usc.edu

Transplant Infectious Disease : an Official Journal of the Transplantation Society
|December 20, 2011
PubMed

Insights

Disseminated coccidioidomycosis occurred in 3 organ recipients from an infected donor. Early serologic testing for Coccidioides immitis in organ donors from endemic areas is crucial for preventing transmission.

Area of Science:

  • Infectious Diseases
  • Transplantation Immunology
  • Mycology

Background:

  • Organ transplantation carries a risk of infectious disease transmission.
  • Coccidioidomycosis is a fungal infection endemic to specific regions.
  • Undiagnosed infections in donors can lead to severe outcomes in recipients.

Observation:

  • Three organ transplant recipients developed disseminated coccidioidomycosis.
  • The infection was traced to a donor with unrecognized meningeal coccidioidomycosis.
  • All recipients presented with symptoms within three weeks post-transplantation.

Findings:

  • Only one of the three organ recipients survived the acute phase of coccidioidomycosis.
  • The donor's meningeal infection was a source of disseminated disease in recipients.
  • Rapid onset of severe symptoms was observed in the transplant recipients.

Implications:

  • Routine serologic screening for Coccidioides immitis in organ donors from endemic areas is recommended.
  • Early detection and management of fungal infections in donors can prevent post-transplant complications.
  • This case highlights the importance of donor screening for endemic mycoses in transplantation.

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