Coccidioidomycosis in Liver Transplant Recipients Relocating to an Endemic Area
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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.
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- 1.Pappagianis D: Epidemiology of coccidioidomycosis. In Cocci- dioidomycosis: A Text. Stevens DA (ed). New York, Plenum Medical Book, 1980, pp 63–85Google Scholar
- 3.Cantanzaro A, Drutz DJ: Primary coccidioidomycosis. In Cocci- dioidomycosis: A Text. Stevens DA (ed). New York, Plenum Medical Book, 1980, pp 139–145Google Scholar
- 6.Calhoun DL, Galgiani JN, Zukoski C, Copeland JG: Cocci- dioidomycosis in recent renal or cardiac transplant recipients. In Coccidioidomycosis: Proceedings of the 4th International Conference on Coccidioidomycosis, San Diego, CA, March 1984. Einstein HE, Cantanzaro A (eds). Washington, DC, National Foundation for Infectious Diseases, 1985, pp 312–318Google Scholar
- 7.Serota AI: The efficacy of fluconazole in prevention of cocci- dioidomycosis following renal transplantation. In Coccidioidomycosis: Proceedings of the 5th International Conference on Cocci- dioidomycosis, Stanford University, 24–27 August 1994: Centennial conference. Einstein HE, Cantanzaro A (eds). Bethesda, MD, National Foundation for Infectious Diseases Press, 1996, pp 248–254Google Scholar
- 13.Palmer DF, Kaufman L, Kaplan W, Cavallaro JJ: Serodiagnosis of Mycotic Diseases. Springfield, IL. Charles C. Thomas, 1977Google Scholar