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Published on: March 1, 2024

Coccidioidomycosis in renal replacement therapy

I M Cohen, J N Galgiani, D Potter

    Archives of Internal Medicine
    |March 1, 1982
    PubMed

    Insights

    Coccidioidomycosis risk in Arizona renal transplant patients is low, with only 6.9% experiencing symptomatic infection. Male sex and blood type B increased dissemination risk, but transplantation remains viable in endemic areas.

    Area of Science:

    • Nephrology
    • Infectious Diseases
    • Mycology

    Background:

    • Renal transplantation in coccidioidomycosis-endemic areas raises safety concerns.
    • Immunosuppressed populations are at higher risk for fungal infections.

    Purpose of the Study:

    • To determine coccidioidomycosis incidence and risk factors in dialysis and renal transplant patients in Arizona.
    • To analyze the clinical course and outcomes of coccidioidomycosis in these patient groups.

    Main Methods:

    • Retrospective chart review of 721 dialysis patients and 260 renal transplant recipients.
    • Analysis of symptomatic infection rates, risk factors (sex, blood type), and diagnostic methods (urine fungal cultures).

    Main Results:

    • Symptomatic coccidioidomycosis occurred in 0.83% of dialysis patients and 6.9% of transplant recipients.
    • Male sex and blood type B were associated with dissemination.
    • Urine fungal cultures proved valuable for diagnosis.
    • Mortality was high (63%) in disseminated cases, but survival was possible.

    Conclusions:

    • The low incidence of coccidioidomycosis does not contraindicate renal transplantation in Arizona.
    • Patients with existing transplants should avoid endemic areas.
    • Risk stratification and careful monitoring are crucial for immunosuppressed patients in endemic regions.

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