Division of Infectious Diseases and Geographic Medicine.
Montreal Heart Institute , Canada.
Open Forum Infect Dis. 2016 May 5;3(3):ofw086. doi: 10.1093/ofid/ofw086. eCollection 2016 Sep.
Background. Endocarditis is a rare manifestation of infection with Coccidioides. This is the first reported case of donor-derived Coccidioides endocarditis obtained from a heart transplant. Methods. We present a unique case of donor-derived Coccidioides immitis endocarditis and disseminated infection in a heart transplant patient. We also conducted a review of the literature to identify other cases of donor-derived coccidioidomycosis in solid organ transplant recipients and reviewed their clinical characteristics. Results. Fifteen prior cases of donor-derived coccidioidomycosis were identified. A majority of these cases were diagnosed by positive culture (83%). Mortality was high at 58%. Conclusions. Clinicians should maintain a high index of suspicion for disseminated coccidioidomycosis in patients who received transplants with organs from donors with a history of residing in endemic regions.
心内膜炎是由球孢子菌感染引起的罕见表现。这是首例从心脏移植供体中获得的、与球孢子菌有关的心内膜炎报道。
我们报告了 1 例心脏移植患者供体来源的新型荚膜组织胞浆菌心内膜炎和播散性感染的独特病例。我们还对文献进行了回顾，以确定其他实体器官移植受者中供体来源的球孢子菌病的病例，并回顾了其临床特征。
共发现 15 例供体来源的球孢子菌病病例。这些病例大多通过阳性培养诊断（83%）。死亡率高达 58%。
对于从有地方性流行病史的供体接受器官移植的患者，临床医生应保持对播散性球孢子菌病的高度警惕。
