Division of Infectious Diseases, Mayo Clinic, Phoenix, AZ, USA.
Transplantation. 2011 Oct 15;92(7):717-21. doi: 10.1097/TP.0b013e31822e6e9a.
Coccidioidomycosis, an endemic fungal infection in the desert southwestern United States, causes substantial morbidity and mortality in immunocompromised hosts. Because lungs are the primary site of coccidioidal infection, lung transplant recipients in endemic areas remain particularly vulnerable. Moreover, direct airway communication to the environment, diminished cough reflex, impaired mucociliary clearance, altered alveolar macrophage function, and ischemic lung injury further enhances the risk of pulmonary infection after lung transplantation. Herein, we review available data on coccidioidomycosis in solid organ transplant recipients and candidates seeking transplantation, and propose strategies for screening, treatment, and prevention of coccidioidal infection in the lung transplant candidate.
球孢子菌病是美国西南部沙漠地区的一种地方性真菌感染，在免疫功能低下的宿主中可导致严重的发病率和死亡率。由于肺部是球孢子菌感染的主要部位，因此在流行地区的肺移植受者仍处于特别脆弱的状态。此外，直接与环境的气道沟通、咳嗽反射减弱、黏液纤毛清除功能受损、肺泡巨噬细胞功能改变以及肺缺血性损伤进一步增加了肺移植后肺部感染的风险。在此，我们回顾了有关实体器官移植受者和候选者中球孢子菌病的现有数据，并提出了针对肺移植候选者中球孢子菌感染的筛查、治疗和预防策略。
