Kokseng S L, Blair J E
Department of Medicine, Mayo Clinic, Scottsdale, Arizona, USA.
Transpl Infect Dis. 2011 Jun;13(3):285-9. doi: 10.1111/j.1399-3062.2010.00576.x. Epub 2010 Oct 5.
Coccidioidomycosis is a fungal infection primarily found in residents or visitors to geographic areas where Coccidioides species are endemic, including the southwestern United States, northwestern Mexico, and certain areas of Central and South America. The infection rarely disseminates, but certain populations are at higher risk of dissemination. One population at high risk of disseminated disease is solid organ transplant recipients. At our transplant center in Arizona, patients with proven coccidioidal infection before transplantation undergo thorough counseling about the risks of dissemination and possible death from coccidioidomycosis subsequent to the use of immunosuppressive medications after transplantation. Currently, patients with coccidioidal infection before transplantation are maintained on lifelong infection suppression with triazole therapy. We present the first successful case of a kidney transplant in a patient after treatment for coccidioidal meningitis without post-transplant reactivation of the coccidioidal infection.
球孢子菌病是一种真菌感染，主要见于球孢子菌属为地方病的地理区域的居民或访客，包括美国西南部、墨西哥西北部以及中美洲和南美洲的某些地区。这种感染很少播散，但某些人群播散的风险较高。实体器官移植受者是播散性疾病的高危人群之一。在我们位于亚利桑那州的移植中心，如果移植前确诊患有球孢子菌感染，患者会接受关于播散风险以及移植后使用免疫抑制药物可能因球孢子菌病死亡的全面咨询。目前，移植前感染球孢子菌的患者通过三唑类疗法进行终身感染抑制。我们报告了首例成功进行肾移植的病例，该患者曾接受球孢子菌性脑膜炎治疗，移植后球孢子菌感染未再激活。
