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Blastomycosis in transplant recipients: report of a case and review
J S Serody1, M R Mill, F C Detterbeck
1Department of Medicine, University of North Carolina School of Medicine, Chapel Hill 27599-7030.
Abstract:
Fungi cause serious, often fatal infections in immunocompromised hosts. Recipients of solid organ and bone marrow transplants are predisposed to invasive fungal infections with Candida species, Aspergillus species, and Cryptococcus neoformans. In contrast, infections with Blastomyces dermatitidis have rarely been diagnosed in transplant recipients. We describe a patient who received an orthotopic heart transplant and developed recurrent disseminated blastomycosis. Other reported cases of blastomycosis in transplant recipients are summarized. Clinical presentation, treatment options, and morbidity associated with infections with B. dermatitidis in transplant patients are reviewed.
Insights
Transplant recipients can develop rare fungal infections like blastomycosis. This study details a heart transplant patient with recurrent disseminated blastomycosis, highlighting treatment and outcomes.
Area of Science:
- Mycology
- Infectious Diseases
- Transplant Medicine
Background:
- Immunocompromised individuals, particularly solid organ and bone marrow transplant recipients, are susceptible to invasive fungal infections.
- Common fungal pathogens in transplant recipients include Candida species, Aspergillus species, and Cryptococcus neoformans.
- Infections caused by Blastomyces dermatitidis are infrequently reported in transplant populations.
Observation:
- A case of recurrent disseminated blastomycosis in an orthotopic heart transplant recipient is presented.
- This highlights a rare but serious complication following organ transplantation.
- The patient's clinical course and management are detailed.
Findings:
- Blastomycosis is an uncommon but significant opportunistic infection in transplant recipients.
- Review of reported cases indicates variability in clinical presentation and treatment response.
- Disseminated blastomycosis can lead to substantial morbidity in this vulnerable patient group.
Implications:
- Increased awareness of Blastomyces dermatitidis as a potential pathogen in transplant recipients is crucial.
- Early diagnosis and appropriate antifungal therapy are essential for managing blastomycosis in transplant patients.
- Further research into risk factors and optimal treatment strategies for fungal infections in transplant recipients is warranted.