Adverse Occurrence type:
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Fever, progressive respiratory distress thick sputum and progressive pulmonary infiltrates developed on day 6 after bilateral lung transplantation for primary pulmonary hypertension.
Demonstration of imputability or root cause:
Level 4 Proven, Certain. Coccidioides immitis found in donor node and recipient lung infection. Donor and recipient from endemic area. When coccidioidomycosis develops in the early postoperative period, transmission from the donor is more likrely than reinfection of latent coccidioidomycosis immitis in the recipient. After respiratory failure and intubation, bronchial washings showed Coccidioidess immitis by culture and microscope. He recovered and was dischaged on day 27. The donor was a hiker from Arizona, USA, with a normal chest XRay but on explantation of the lung a small hilar node was found. Later histologic exam showed Coccidiomycosis immitis.