Respiratory Failure due to Possible Donor-Derived Sporothrix schenckii Infection in a Lung Transplant Recipient

Background. De novo and donor-derived invasive fungal infections (IFIs) contribute to morbidity and mortality in solid organ transplant (SOT) recipients. Reporting of donor-derived IFIs (DDIFIs) to the Organ Procurement Transplant Network has been mandated since 2005. Prior to that time no systemati...

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Main Authors: Nathan C. Bahr, Katherine Janssen, Joanne Billings, Gabriel Loor, Jaime S. Green
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2015/925718
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author Nathan C. Bahr
Katherine Janssen
Joanne Billings
Gabriel Loor
Jaime S. Green
author_facet Nathan C. Bahr
Katherine Janssen
Joanne Billings
Gabriel Loor
Jaime S. Green
author_sort Nathan C. Bahr
collection DOAJ
description Background. De novo and donor-derived invasive fungal infections (IFIs) contribute to morbidity and mortality in solid organ transplant (SOT) recipients. Reporting of donor-derived IFIs (DDIFIs) to the Organ Procurement Transplant Network has been mandated since 2005. Prior to that time no systematic monitoring of DDIFIs occurred in the United States. Case Presentation. We report a case of primary graft dysfunction in a 49-year-old male lung transplant recipient with diffuse patchy bilateral infiltrates likely related to pulmonary Sporothrix schenckii infection. The organism was isolated from a bronchoalveolar lavage on the second day after transplantation. Clinical and radiographic responses occurred after initiation of amphotericin B lipid formulation. Conclusion. We believe that this was likely a donor-derived infection given the early timing of the Sporothrix isolation after transplant in a bilateral single lung transplant recipient. This is the first case report of sporotrichosis in a lung transplant recipient. Our patient responded well to amphotericin induction therapy followed by maintenance therapy with itraconazole. The implications of donor-derived fungal infections and Sporothrix in transplant recipients are reviewed. Early recognition and management of these fungi are essential in improving outcomes.
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spelling doaj-art-13d2273a159441118946e7de19d937732025-02-03T06:07:16ZengWileyCase Reports in Infectious Diseases2090-66252090-66332015-01-01201510.1155/2015/925718925718Respiratory Failure due to Possible Donor-Derived Sporothrix schenckii Infection in a Lung Transplant RecipientNathan C. Bahr0Katherine Janssen1Joanne Billings2Gabriel Loor3Jaime S. Green4Division of Infectious Disease and International Medicine, Department of Medicine, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 250, Minneapolis, MN 55455, USADepartment of Medicine, University of Minnesota, 401 East River Parkway, VCRC 1st Floor, Suite 131, Minneapolis, MN 55455, USADivision of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 276, Minneapolis, MN 55455, USADivision of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 207, Minneapolis, MN 55455, USADivision of Infectious Disease and International Medicine, Department of Medicine, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 250, Minneapolis, MN 55455, USABackground. De novo and donor-derived invasive fungal infections (IFIs) contribute to morbidity and mortality in solid organ transplant (SOT) recipients. Reporting of donor-derived IFIs (DDIFIs) to the Organ Procurement Transplant Network has been mandated since 2005. Prior to that time no systematic monitoring of DDIFIs occurred in the United States. Case Presentation. We report a case of primary graft dysfunction in a 49-year-old male lung transplant recipient with diffuse patchy bilateral infiltrates likely related to pulmonary Sporothrix schenckii infection. The organism was isolated from a bronchoalveolar lavage on the second day after transplantation. Clinical and radiographic responses occurred after initiation of amphotericin B lipid formulation. Conclusion. We believe that this was likely a donor-derived infection given the early timing of the Sporothrix isolation after transplant in a bilateral single lung transplant recipient. This is the first case report of sporotrichosis in a lung transplant recipient. Our patient responded well to amphotericin induction therapy followed by maintenance therapy with itraconazole. The implications of donor-derived fungal infections and Sporothrix in transplant recipients are reviewed. Early recognition and management of these fungi are essential in improving outcomes.http://dx.doi.org/10.1155/2015/925718
spellingShingle Nathan C. Bahr
Katherine Janssen
Joanne Billings
Gabriel Loor
Jaime S. Green
Respiratory Failure due to Possible Donor-Derived Sporothrix schenckii Infection in a Lung Transplant Recipient
Case Reports in Infectious Diseases
title Respiratory Failure due to Possible Donor-Derived Sporothrix schenckii Infection in a Lung Transplant Recipient
title_full Respiratory Failure due to Possible Donor-Derived Sporothrix schenckii Infection in a Lung Transplant Recipient
title_fullStr Respiratory Failure due to Possible Donor-Derived Sporothrix schenckii Infection in a Lung Transplant Recipient
title_full_unstemmed Respiratory Failure due to Possible Donor-Derived Sporothrix schenckii Infection in a Lung Transplant Recipient
title_short Respiratory Failure due to Possible Donor-Derived Sporothrix schenckii Infection in a Lung Transplant Recipient
title_sort respiratory failure due to possible donor derived sporothrix schenckii infection in a lung transplant recipient
url http://dx.doi.org/10.1155/2015/925718
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