TY  - JOUR
AU  - Eugene Beaird, Omer
AU  - Nanayakkara, Deepa
AU  - Gaynor, Pryce
AU  - Schaenman, Joanna
PY  - 2019
DA  - 2019/07/26
TI  - Endemic Mycoses and Cryptococcus in Solid Organ Transplant Recipients
JO  - OBM Transplantation
SP  - 075
VL  - 03
IS  - 03
AB  - The endemic mycoses are an important cause of morbidity and mortality in transplant recipients. These fungal infections are notable for their dimorphic life cycle, specific geographic distributions, and typical infection via environmental exposure. Their nonspecific presentation can make diagnosis challenging. Because of their geographic associations, assessment of both donor and recipient history is critical in making an accurate and timely diagnosis. Coccidioides spp. are endemic to the southwestern United States and can cause severe pneumonia, meningitis, as well as bone and joint infection. Coccidioidomycosis is unique in its likelihood to reactivate following immunosuppression compared with the other endemic fungal infections. For this reason, recipients with even remote history of infection benefit from secondary prophylaxis to prevent reactivation. Histoplasmosis in North America typically occurs in the Mississippi and Ohio River valleys, however is distributed worldwide. Histoplasmosis presents as pneumonia and frequently with disseminated disease. Blastomycosis has an overlapping geographic distribution with Histoplasmosis but is less commonly seen in transplant recipients. Cryptococcus does not have a dimorphic form. However, it is an environmental fungus and has a presentation similar to the endemic fungi, and is therefore discussed in this review. Amphotericin B and the azole antifungals are commonly used to treat or prevent these infections. However, despite the availability of effective therapy delays in diagnosis can result in adverse clinical outcomes.
SN  - 2577-5820
UR  - https://doi.org/10.21926/obm.transplant.1903075
DO  - 10.21926/obm.transplant.1903075
ID  - Eugene Beaird2019
ER  -