Blastomycosis in solid organ transplant recipients-A retrospective series from southeastern Wisconsin. Transpl Infect Dis 2021 Aug;23(4):e13671
Date
06/20/2021Pubmed ID
34146378DOI
10.1111/tid.13671Scopus ID
2-s2.0-85109628154 (requires institutional sign-in at Scopus site) 5 CitationsAbstract
Blastomycosis is a fungal infection caused primarily by Blastomyces dermatitis. The fungus is endemic to the Ohio, Mississippi, and St. Lawrence River areas of the United States. Organ transplant recipients are at risk of blastomycosis due to pharmacologic immunosuppression. Over a 20-year period, 30 cases of blastomycosis post-solid organ transplantation were identified at our center. The cumulative incidence of blastomycosis among SOT recipients was 0.99%. There was a male predominance (70% male) and a median age of 59 at the time of diagnosis. Regarding transplant type, 23 patients received kidney transplants, 4 received liver transplants, 2 received pancreas transplants and 1 received a heart transplant. Median time to blastomycosis identification post-transplant was 67.8 months (range: 1-188 months). Amphotericin B was used as initiation therapy in most cases, followed by itraconazole, voriconazole, or in select cases fluconazole or posaconazole maintenance therapy. Regarding comorbid conditions, 87% of patients had diabetes, 50% had congestive heart failure, and 20% had chronic pulmonary disease. Nine patients (30%) developed blastomycosis-related acute respiratory distress syndrome, 33% of these died with a median time to death of 22 days (range 20 days to 2 months); these were the only deaths attributable to blastomycosis.
Author List
Mehta TI, Kurman J, Dolan S, Gill H, Thapa BAuthors
Jonathan S. Kurman MD Assistant Professor in the Medicine department at Medical College of WisconsinBipin Thapa MD Assistant Dean, Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Antifungal AgentsBlastomycosis
Female
Humans
Male
Organ Transplantation
Retrospective Studies
United States
Wisconsin
