Coccidioidomycosis in patients who have undergone transplantation

Janis E. Blair

Research output: Chapter in Book/Report/Conference proceedingConference contribution

44 Scopus citations

Abstract

In the early years of transplantation in Arizona, coccidioidomycosis occurred in 7% to 9% of recipients, with a mortality rate as high as 72% in some cases. In current transplant programs, however, evolution of immunosuppression and institution of targeted prophylaxis have resulted in coccidioidal infection rates ranging from 1% to 2%. The clinical characteristics of this infection among transplant recipients range from asymptomatic to fulminant and fatal. Dissemination is common, and mortality is high (28%). Because serologic response is often absent or slow, diagnosis can be challenging and often requires invasive diagnostic procedures. Pharmacologic treatment follows the guidelines of the Infectious Diseases Society of America, but control of infection may also dictate a decrease in immunosuppressant treatment. After infection is controlled, secondary azole prophylaxis is recommended to prevent relapse. Patients with a history of coccidioidomycosis may undergo successful transplantation when disease is inactive and azole prophylaxis is instituted. The incidence of donor-derived coccidioidomycosis is not known. The risk of coccidioidal infection among transplant recipients visiting in or relocating to an endemic area is low, and routine prophylaxis for this group is not recommended.

Original languageEnglish (US)
Title of host publicationCoccidioidomycosis Sixth International Symposium
PublisherBlackwell Publishing Inc.
Pages365-376
Number of pages12
ISBN (Print)1573316881, 9781573316880
DOIs
StatePublished - Sep 2007

Publication series

NameAnnals of the New York Academy of Sciences
Volume1111
ISSN (Print)0077-8923
ISSN (Electronic)1749-6632

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Keywords

  • Coccidioidomycosis
  • Fungal infections
  • Organ transplantation

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • History and Philosophy of Science

Cite this

Blair, J. E. (2007). Coccidioidomycosis in patients who have undergone transplantation. In Coccidioidomycosis Sixth International Symposium (pp. 365-376). (Annals of the New York Academy of Sciences; Vol. 1111). Blackwell Publishing Inc.. https://doi.org/10.1196/annals.1406.009