Coccidioidal pneumonia, arthritis, and soft-tissue infection after kidney transplantation


Correspondence to:
Janis E. Blair, MD,
Division of Infectious Diseases,
Mayo Clinic,
13400 East Shea Boulevard,
Scottsdale, AZ 85259
Fax: 480-342-2324


Abstract: A 60-year-old male kidney transplant recipient presented with pneumonia 4 months after transplantation. Coccidioidomycosis was suspected and empirically treated with fluconazole. He was maintained on suppressive fluconazole without problems. Three weeks after discontinuing secondary prophylaxis, the patient experienced coccidioidal arthritis and an infection of the soft tissue of the hand that required debridement. Transplant recipients may have quiescent disseminated coccidioidomycosis that is reactivated by immunosuppression after withdrawal of suppressive antifungal therapy.