02951nas a2200373   4500008003900000245009800039210006900137260000800206300000700214490000800221520196500229100001602194700001602210700001302226700001802239700001702257700001602274700001202290700001702302700001402319700001702333700001502350700001602365700001302381700001502394700001602409700001802425700001602443700001802459700001502477700001902492700001702511856004902528       2014                          d00aMicrosporidiosis acquired through solid organ transplantation: a public health investigation.0 aMicrosporidiosis acquired through solid organ transplantation a   cFeb  a130 v1603 aBACKGROUND:

Encephalitozoon cuniculi, a microsporidial species most commonly recognized as a cause of renal, respiratory, and central nervous system infections in immunosuppressed patients, was identified as the cause of a temporally associated cluster of febrile illness among 3 solid organ transplant recipients from a common donor.
OBJECTIVE:

To confirm the source of the illness, assess donor and recipient risk factors, and provide therapy recommendations for ill recipients.
DESIGN:

Public health investigation.
SETTING:

Two transplant hospitals and community interview with the deceased donor's family.
PATIENTS:

Three transplant recipients and the organ donor.
MEASUREMENTS:

Specimens were tested for microsporidia by using culture, immunofluorescent antibody, polymerase chain reaction,immunohistochemistry, and electron microscopy. Donor medical records were reviewed and a questionnaire was developed to assess for microsporidial infection.
RESULTS:

Kidneys and lungs were procured from the deceased donor and transplanted to 3 recipients who became ill with fever 7 to 10 weeks after the transplant. Results of urine culture, serologic,and polymerase chain reaction testing were positive for E. cuniculi of genotype III in each recipient; the organism was also identified in biopsy or autopsy specimens in all recipients. The donor had positive serologic test results for E. cuniculi. Surviving recipients received albendazole. Donor assessment did not identify factors for suspected E. cuniculi infection.
LIMITATION:

Inability to detect organism by culture or polymerase chain reaction in donor due to lack of autopsy specimens.
CONCLUSION:

Microsporidiosis is now recognized as an emerging transplant-associated disease and should be considered in febrile transplant recipients when tests for routinely encountered agents are unrevealing. Donor-derived disease is critical to assess when multiple recipients from a common donor are ill.1 aHocevar, SN1 aPaddock, CD1 aSpak, CW1 aRosenblatt, R1 aDiaz-Luna, H1 aCastillo, I1 aLuna, S1 aFriedman, GC1 aAntony, S1 aStoddard, RA1 aTiller, RV1 aPeterson, T1 aBlau, DM1 aSriram, RR1 ada Silva, A1 ade Almeida, M1 aBenedict, T1 aGoldsmith, CS1 aZaki, S, R1 aVisvesvara, GS1 aKuehnert, MJ  uhttps://www.notifylibrary.org/reference/4640