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Outcomes of Coccidioides Seropositive Solid Organ Transplant Recipients After Self-discontinuation of Antifungal Prophylaxis: The EIA-IgM-only Conundrum.
Transplantation
January 2025
Division of Infectious Diseases, Mayo Clinic, Phoenix, AZ.
Background: Solid organ transplant recipients are at risk of severe coccidioidomycosis and are given prophylaxis to mitigate the risk. Patients with seropositive testing typically receive lifelong prophylaxis; currently, this prophylaxis strategy includes patients who are positive only for IgM by enzyme immunoassay (EIA-IgM-only), although this result may be falsely positive.
Methods: We conducted a retrospective study at a large-volume transplant center in an endemic coccidioidomycosis region to compare outcomes of non-lung transplant recipients who were seropositive for Coccidioides but discontinued prophylaxis (case patients) to outcomes of patients who continued prophylaxis (controls).
Estimating the Exposure-Response Relationship between Fine Mineral Dust Concentration and Coccidioidomycosis Incidence Using Speciated Particulate Matter Data: A Longitudinal Surveillance Study.
Environ Health Perspect
January 2025
Department of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Nevada, Reno, Reno, Nevada, USA.
Background: Coccidioidomycosis, caused by inhalation of spp. spores, is an emerging infectious disease that is increasing in incidence throughout the southwestern US. The pathogen is soil-dwelling, and spore dispersal and human exposure are thought to co-occur with airborne mineral dust exposures, yet fundamental exposure-response relationships have not been conclusively estimated.
View Article and Find Full Text PDFOptimizing spherulation cues in the fungal pathogen .
mSphere
December 2024
Department of Microbiology and Immunology, University of California San Francisco, San Francisco, California, USA.
spp. are part of a group of thermally dimorphic fungal pathogens, which grow as filamentous cells (hyphae) in the soil and transform to a different morphology upon inhalation into the host. The host form, the spherule, is unique and highly undercharacterized due to both technical and biocontainment challenges.
View Article and Find Full Text PDFSpatiotemporal analysis of lung immune dynamics in lethal infection.
mBio
November 2024
Physical and Life Sciences Directorate, Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, California, USA.
Coccidioidomycosis, or Valley fever, is a lung disease caused by inhalation of fungi, prevalent in the Southwestern United States, Mexico, and parts of Central and South America. Annually, the United States reports 10,000-20,000 cases, although those numbers are expected to increase as climate change expands the fungal geographic range. While 60% of infections are asymptomatic, 40% symptomatic infections are often misdiagnosed due to similarities with bronchitis or pneumonia.
View Article and Find Full Text PDFCoccidioidomycosis Transmission Through Solid Organ Transplantation (2013-2022): A Report of the Organ Procurement and Transplantation Network ad hoc Disease Transmission Advisory Committee.
Transpl Infect Dis
November 2024
Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio, USA.
Article Synopsis
- Coccidioidomycosis is a serious fungal infection that can be transmitted through organ transplantation, with a review of cases from 2013 to 2022 revealing significant risks.
- Seven deceased donors transmitted the infection to eight recipients, resulting in a 40% infection rate among organ recipients.
- The study highlights the importance of thorough donor evaluations and antifungal treatment to reduce the high mortality associated with these infections post-transplant.
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