Single-center experience of antifungal prophylaxis for coccidioidomycosis in heart transplant recipients within an endemic area

Graham M. Lohrmann, Darko Vucicevic, Romy Lawrence, D Eric Steidley, Robert L Scott, Shimon Kusne, Janis E. Blair

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

In endemic regions, coccidioidomycosis causes substantial morbidity and mortality for patients receiving solid organ transplants. We aimed to demonstrate the effect of antifungal coccidioidal prophylaxis in heart transplant (HT) recipients. We retrospectively reviewed the electronic health records of all patients who received HTs between October 19, 2005, and December 13, 2014. We collected information regarding antifungal regimens and determined whether patients subsequently developed infections. Our 174-person cohort all received antifungal prophylaxis for at least 6 months (mean follow-up, 53.8 months). One proven and one probable coccidioidal infection (each, 0.6%) occurred during the study period. The incidence of coccidioidomycosis was 0.6% at 1 year and 2.3% at 5 years. No cases of proven coccidioidomycosis occurred within 2 years after transplantation. No patients developed disseminated disease, and no sentinel events were attributed to coccidioidomycosis. Both fluconazole and voriconazole were well tolerated. In the absence of intolerance or contraindication, we suggest continuing a universal antifungal prophylactic regimen with fluconazole for at least 6-12 months in HT recipients residing in a coccidioidomycosis-endemic area.

Original languageEnglish (US)
JournalTransplant Infectious Disease
DOIs
StateAccepted/In press - 2017

Fingerprint

Coccidioidomycosis
Fluconazole
Electronic Health Records
Infection
Transplantation
Transplant Recipients
Morbidity
Transplants
Mortality
Incidence

Keywords

  • Antifungal
  • Coccidioidomycosis
  • Heart transplant
  • Prophylaxis
  • Solid organ transplant

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

Cite this

Single-center experience of antifungal prophylaxis for coccidioidomycosis in heart transplant recipients within an endemic area. / Lohrmann, Graham M.; Vucicevic, Darko; Lawrence, Romy; Steidley, D Eric; Scott, Robert L; Kusne, Shimon; Blair, Janis E.

In: Transplant Infectious Disease, 2017.

Research output: Contribution to journalArticle

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abstract = "In endemic regions, coccidioidomycosis causes substantial morbidity and mortality for patients receiving solid organ transplants. We aimed to demonstrate the effect of antifungal coccidioidal prophylaxis in heart transplant (HT) recipients. We retrospectively reviewed the electronic health records of all patients who received HTs between October 19, 2005, and December 13, 2014. We collected information regarding antifungal regimens and determined whether patients subsequently developed infections. Our 174-person cohort all received antifungal prophylaxis for at least 6 months (mean follow-up, 53.8 months). One proven and one probable coccidioidal infection (each, 0.6{\%}) occurred during the study period. The incidence of coccidioidomycosis was 0.6{\%} at 1 year and 2.3{\%} at 5 years. No cases of proven coccidioidomycosis occurred within 2 years after transplantation. No patients developed disseminated disease, and no sentinel events were attributed to coccidioidomycosis. Both fluconazole and voriconazole were well tolerated. In the absence of intolerance or contraindication, we suggest continuing a universal antifungal prophylactic regimen with fluconazole for at least 6-12 months in HT recipients residing in a coccidioidomycosis-endemic area.",
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AU - Scott, Robert L

AU - Kusne, Shimon

AU - Blair, Janis E.

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