De novo coccidioidomycosis among solid organ transplant recipients 1 or more years after transplant

Kara Asbury, Janis E. Blair, Jessica August, Norman L. Beatty, Lanyu Mi, Elizabeth J. Carey, Janna L. Huskey, Lisa M. LeMond, Tirdad T Zangeneh

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Solid organ transplant recipients who contract coccidioidomycosis are at risk for complicated, protracted, disseminated, and severe disease. To date, no studies have described outcomes for patients who develop coccidioidomycosis only after the first posttransplant year. This study was a joint project of Mayo Clinic Hospital, Phoenix, Arizona, and the University of Arizona/Banner University Medical Center, Tucson, Arizona. We retrospectively reviewed electronic health records for patients with a history of solid organ transplant between January 1, 1998, and October 11, 2014, who developed coccidioidomycosis after the first transplant year. We identified 91 patients. Of those, 37/91 (40.7%) had pulmonary coccidioidomycosis (29/37 [78.4%] were symptomatic); and 5/91 (5.5%) had extrapulmonary disease (all were symptomatic). One patient (1.1%) died. Coccidioidomycosis was evident in 2/91 (2.2%) patients within 3 months of antirejection treatment. Many of the patients (51/91 [56.0%]) had asymptomatic coccidioidomycosis, 27 (27.9%) of whom were followed up closely but did not receive antifungal medication and had no sequelae. Although solid organ recipients taking low-level immunosuppression after the first posttransplant year appeared to have less symptomatic, disseminated, or fatal coccidioidal infection than historical cohorts, this remains an important infection with morbidity and mortality even after the first posttransplant year.

Original languageEnglish (US)
JournalAmerican Journal of Transplantation
DOIs
StatePublished - Jan 1 2019

Fingerprint

Coccidioidomycosis
Transplants
Electronic Health Records
Infection
Immunosuppression
Transplant Recipients
Morbidity
Lung
Mortality

Keywords

  • clinical research/practice
  • complication: infectious
  • infection and infectious agents – fungal
  • infectious disease
  • lung disease: infectious
  • organ transplantation in general

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

De novo coccidioidomycosis among solid organ transplant recipients 1 or more years after transplant. / Asbury, Kara; Blair, Janis E.; August, Jessica; Beatty, Norman L.; Mi, Lanyu; Carey, Elizabeth J.; Huskey, Janna L.; LeMond, Lisa M.; Zangeneh, Tirdad T.

In: American Journal of Transplantation, 01.01.2019.

Research output: Contribution to journalArticle

Asbury, Kara ; Blair, Janis E. ; August, Jessica ; Beatty, Norman L. ; Mi, Lanyu ; Carey, Elizabeth J. ; Huskey, Janna L. ; LeMond, Lisa M. ; Zangeneh, Tirdad T. / De novo coccidioidomycosis among solid organ transplant recipients 1 or more years after transplant. In: American Journal of Transplantation. 2019.
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