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Coccidioidomycosis in healthy persons evaluated for liver or kidney donation

Authors


  • Portions of this manuscript have been presented in abstract form at the Interscience Conference on Antimicrobial Agents and Chemotherapy, Washington, DC, December 16–19, 2005.


Janis E. Blair, MD, Division of Infectious Diseases, Mayo Clinic, 13400 East Shea Boulevard, Scottsdale, AZ 85259 USA
E-mail: Blair.Janis@mayo.edu

Abstract

Abstract: Coccidioidomycosis is a fungal infection caused by Coccidioides species endemic to the southwestern United States, where it poses unique challenges for transplant recipients. Donor-derived coccidioidomycosis has been documented, but its risk of transmission is not known. We prospectively screened 568 healthy persons requesting evaluation for possible liver or kidney donation. Twelve (2.1%) of the 568 donor candidates were seropositive (11 initially and 1 with seroconversion and symptomatic illness within 1 week after negative screening). Three of these 12 patients proceeded to kidney donation, and a fourth patient proceeded to liver donation. None of the 4 transplant recipients received special coccidioidal prophylaxis, although all were administered fluconazole according to standard antifungal prophylaxis protocols. At follow-up (7–54 months), no coccidioidomycosis was identified in any recipient. The prevalence of coccidioidal antibodies was low among potential organ donor candidates, but the risk of donor-derived coccidioidomycosis remains unknown and further study is warranted.

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