Coccidioidomycosis in liver transplant recipients relocating to an endemic area

Coccidioidomycosis is an endemic fungal infection of the desert southwestern United States. This infection occurs at a rate of 1% to 8% in solid organ transplant recipients residing in the endemic area, and it has a high rate of disseminated infection and mortality. The risk of infection among trans...

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Bibliographic Details
Published in:Digestive diseases and sciences 2004-11, Vol.49 (11-12), p.1981-1985
Main Authors: BLAIR, Janis E, DOUGLAS, David D
Format: Article
Language:English
Subjects:
Adult
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antifungal agents
Arizona - epidemiology
Biological and medical sciences
Coccidioidomycosis
Coccidioidomycosis - epidemiology
Coccidioidomycosis - etiology
Endemic Diseases - prevention & control
Female
Human mycoses
Humans
Incidence
Infectious diseases
Liver Transplantation - adverse effects
Male
Medical sciences
Mycoses
Opportunistic Infections - epidemiology
Opportunistic Infections - etiology
Opportunistic Infections - prevention & control
Pharmacology. Drug treatments
Retrospective Studies
Risk Factors
Tropical mycoses
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Summary:Coccidioidomycosis is an endemic fungal infection of the desert southwestern United States. This infection occurs at a rate of 1% to 8% in solid organ transplant recipients residing in the endemic area, and it has a high rate of disseminated infection and mortality. The risk of infection among transplant recipients from nonendemic areas visiting or moving to an endemic region is not known. We reviewed the clinical course of 41 liver transplant recipients who originally resided in and underwent liver transplantation in an area of low coccidioidal endemicity and who later relocated their follow-up care to our program, which is located in an endemic area. No patients received antifungal prophylaxis to prevent primary coccidioidomycosis. Among 37 patients with at least 1 year of follow-up care, the incidence of new coccidioidal infection was 2.7%. Coccidioidomycosis was identified in one patient and was manifested by fatigue, anemia, and pulmonary nodules. This patient survived with oral antifungal therapy. Coccidioidomycosis was not a frequent event in liver transplant recipients from areas of low endemicity who relocated to our highly endemic area.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-004-9605-0