02270nas a2200289   4500008003900000245013500039210006900174260000800243300000600251490000700257520135700264653002701621653003301648653002901681653005001710653001101760653003601771653002301807100001301830700001501843700001701858700001301875700001701888700001301905700001301918856004901931       2016                          d00aCoccidioidomycosis Transmission Through Organ Transplantation: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee0 aCoccidioidomycosis Transmission Through Organ Transplantation A   cDec  a20 v163 aDonor-derived coccidioidomycosis has caused unexpected morbidity and mortality in transplant recipients. All proven or probable reports of donor-derived coccidioidomycosis to the Disease Transmission Advisory Committee between 2005 and August 2012 were reviewed. Six reports of proven or probable coccidioidomycosis were discovered. In four of six, the infection was first detected at autopsy in the recipient. In two cases it was first identified in the donor. Twenty-one recipients received organs from these six donors. Transmission occurred in 43% at a median of 30 days posttransplant with a mortality rate of 28.5%. Eleven recipients received preemptive antifungals, seven did not receive treatment, and treatment information was not reported for three recipients. Five of seven who did not receive prophylaxis/treatment died and all 11 who received early therapy survived. Six deaths occurred 14 to 55 days after transplant, with a median of 21 days. For exposed recipients, donor-derived coccidioidomycosis is a significant cause of morbidity and mortality. Evidence of infection in one recipient should prompt immediate evaluation for treatment of all other recipients from the same donor as preemptive treatment was effective. Further studies are needed to decide whether all donors from endemic areas should have routine serologic screening.10aantibiotic: antifungal10aclinical research / practice10acomplication: infectious10adonors and donation: donor-derived infections10aFungal10ainfection and infectious agents10ainfectious disease1 aKusne, S1 aTaranto, S1 aCovington, S1 aKaul, DR1 aBlumberg, EA1 aWolfe, C1 aGreen, M  uhttps://www.notifylibrary.org/reference/4645