Sepsis-like histoplasmosis in a kidney transplant patient

Fernandes, Ana Raquel; Viana, Laila Almeida; Mansur, Juliana; Françoso, Mariana de Moraes; Santos, Daniel Wagner de Castro Lima; Silva, Helio Tedesco; Pestana, José Osmar Medina

doi:10.1590/1678-4685-jbn-3767

Cited by 5 publications

(1 citation statement)

References 23 publications

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“…Nineteen coinfections were described ( Supplementary Material, Appendix 2 ) [ 97 , 101 , 108 , 122 , 128 , 129 , 153 , 159 , 163 , 171 , 180 , 199 , 208 , 243 ]. Of the 42 patients who died [ 74 , 77–79 , 81 , 82 , 84 , 87 , 90 , 95 , 108 , 115 , 127 , 128 , 139 , 141 , 142 , 148 , 153 , 155 , 159–161 , 163 , 164 , 171 , 178 , 179 , 181 , 199–201 , 208 , 241–243 ], the majority had disseminated histoplasmosis (39 of 42 [92.9%]).…”

Section: Resultsmentioning

confidence: 99%

Clinical Characteristics and Outcomes of Endemic Mycoses After Solid Organ Transplantation: A Comprehensive Review

Abad,

Razonable

2024

Open Forum Infectious Diseases

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Background Geographically endemic fungi can cause significant disease among solid organ transplant (SOT) recipients. We provide an update on the epidemiology, clinical presentation and outcomes of 5 endemic mycoses in SOT recipients. Methods Multiple databases were reviewed from inception through May 2023 using key words for endemic fungi (e.g. Coccidioidomycosis or Coccidioides, Histoplasmosis or histoplasma, etc.). We included adult SOT recipients and publications in English or with English translation. Results Among 16 cohort studies that reported on blastomycosis (n=3), coccidioidomycosis (n=5), histoplasmosis (n=4), and various endemic mycoses (n=4), the incidence rates varied: coccidioidomycosis (1.2-5.8%); blastomycosis (0.14-0.99%) and histoplasmosis (0.4-1.1%). There were 204 reports that described 268 unique cases of endemic mycoses, including 172 histoplasmosis, 31 blastomycosis, 34 coccidioidomycosis, 6 paracoccidioidomycosis, and 25 talaromycosis. The majority of patients were male (176/261, 67.4%). Transplanted allografts were mostly kidney (191/268, 71.3%), followed by liver (n=39, 14.6%), heart (n=18, 6.7%), lung (n=13, 4.9%), combined kidney-liver, and kidney-pancreas (n=6, 2.7%). In all five endemic mycoses, most patients presented with fever (162/232, 69.8%) and disseminated disease (179/268, 66.8%). Cytopenias were frequently reported for histoplasmosis (71/91, 78.0%), coccidioidomycosis (8/11, 72.7%) and talaromycosis (7/8, 87.5%). Graft loss was reported in 12/136 patients (8.8%). All-cause mortality was reported in 71/267 (26.6%); half (n=34, 50%) of the deaths were related to the underlying mycoses. Conclusions Endemic mycoses commonly present with fever, cytopenias and disseminated disease in SOT recipients. There is a relatively high rate of all-cause mortality, including many that were attributed to endemic mycoses.

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