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Donor-Derived Coccidioides immitis Endocarditis and Disseminated Infection in the Setting of Solid Organ Transplantation.

Nelson JK, Giraldeau G, Montoya JG, Deresinski S, Ho DY, Pham M - Open Forum Infect Dis (2016)

Bottom Line: Results.  Fifteen prior cases of donor-derived coccidioidomycosis were identified.A majority of these cases were diagnosed by positive culture (83%).Mortality was high at 58%.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and Geographic Medicine.

ABSTRACT
Background.  Endocarditis is a rare manifestation of infection with Coccidioides. This is the first reported case of donor-derived Coccidioides endocarditis obtained from a heart transplant. Methods.  We present a unique case of donor-derived Coccidioides immitis endocarditis and disseminated infection in a heart transplant patient. We also conducted a review of the literature to identify other cases of donor-derived coccidioidomycosis in solid organ transplant recipients and reviewed their clinical characteristics. Results.  Fifteen prior cases of donor-derived coccidioidomycosis were identified. A majority of these cases were diagnosed by positive culture (83%). Mortality was high at 58%. Conclusions.  Clinicians should maintain a high index of suspicion for disseminated coccidioidomycosis in patients who received transplants with organs from donors with a history of residing in endemic regions.

No MeSH data available.


Related in: MedlinePlus

(A) Periodic acid-Schiff stain of epicardial tissue showing spherules consistent with Coccidioides infection. (B) Periodic acid-Schiff stain of left atrial mycotic thrombus showing fungal hyphal elements.
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OFW086F2: (A) Periodic acid-Schiff stain of epicardial tissue showing spherules consistent with Coccidioides infection. (B) Periodic acid-Schiff stain of left atrial mycotic thrombus showing fungal hyphal elements.

Mentions: Post mortem examination revealed a mycotic aortic aneurysm at the anastomotic site with infection extending to the pericardium, right ventricular myocardium, pulmonary artery trunk, and left atrial anastomosis with a 2 cm pedunculated left atrial mycotic thrombus (Figure 1). Histopathology revealed spherules and hyphal elements (arthroconidia) consistent with Coccidioides (Figure 2). Autopsy also showed evidence of disseminated fungal infection involving lungs and brain.Figure 1.


Donor-Derived Coccidioides immitis Endocarditis and Disseminated Infection in the Setting of Solid Organ Transplantation.

Nelson JK, Giraldeau G, Montoya JG, Deresinski S, Ho DY, Pham M - Open Forum Infect Dis (2016)

(A) Periodic acid-Schiff stain of epicardial tissue showing spherules consistent with Coccidioides infection. (B) Periodic acid-Schiff stain of left atrial mycotic thrombus showing fungal hyphal elements.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940450&req=5

OFW086F2: (A) Periodic acid-Schiff stain of epicardial tissue showing spherules consistent with Coccidioides infection. (B) Periodic acid-Schiff stain of left atrial mycotic thrombus showing fungal hyphal elements.
Mentions: Post mortem examination revealed a mycotic aortic aneurysm at the anastomotic site with infection extending to the pericardium, right ventricular myocardium, pulmonary artery trunk, and left atrial anastomosis with a 2 cm pedunculated left atrial mycotic thrombus (Figure 1). Histopathology revealed spherules and hyphal elements (arthroconidia) consistent with Coccidioides (Figure 2). Autopsy also showed evidence of disseminated fungal infection involving lungs and brain.Figure 1.

Bottom Line: Results.  Fifteen prior cases of donor-derived coccidioidomycosis were identified.A majority of these cases were diagnosed by positive culture (83%).Mortality was high at 58%.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases and Geographic Medicine.

ABSTRACT
Background.  Endocarditis is a rare manifestation of infection with Coccidioides. This is the first reported case of donor-derived Coccidioides endocarditis obtained from a heart transplant. Methods.  We present a unique case of donor-derived Coccidioides immitis endocarditis and disseminated infection in a heart transplant patient. We also conducted a review of the literature to identify other cases of donor-derived coccidioidomycosis in solid organ transplant recipients and reviewed their clinical characteristics. Results.  Fifteen prior cases of donor-derived coccidioidomycosis were identified. A majority of these cases were diagnosed by positive culture (83%). Mortality was high at 58%. Conclusions.  Clinicians should maintain a high index of suspicion for disseminated coccidioidomycosis in patients who received transplants with organs from donors with a history of residing in endemic regions.

No MeSH data available.


Related in: MedlinePlus