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Coccidioidomycosis in Allogeneic Stem Cell Transplant Recipients: Case Series and Review of the Literature

Coccidioides is an endemic fungus of the Southwest United States that causes the disease coccidioidomycosis. Immunocompromised persons are at increased risk for severe infection and dissemination. One such population is allogeneic bone marrow transplant (allo-HCT) recipients, but accounts of coccidi...

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Autores principales: Saling, Christopher F., Gea-Banacloche, Juan, Trickett, John S., Blair, Janis E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145758/
https://www.ncbi.nlm.nih.gov/pubmed/33925759
http://dx.doi.org/10.3390/jof7050339
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author Saling, Christopher F.
Gea-Banacloche, Juan
Trickett, John S.
Blair, Janis E.
author_facet Saling, Christopher F.
Gea-Banacloche, Juan
Trickett, John S.
Blair, Janis E.
author_sort Saling, Christopher F.
collection PubMed
description Coccidioides is an endemic fungus of the Southwest United States that causes the disease coccidioidomycosis. Immunocompromised persons are at increased risk for severe infection and dissemination. One such population is allogeneic bone marrow transplant (allo-HCT) recipients, but accounts of coccidioidal infection in these patients have rarely been documented. We present two cases of Coccidioides in allo-HCT recipients with good outcomes: one patient who developed pulmonary coccidioidomycosis in the late post-engraftment phase and another with known controlled disseminated infection at the time of transplant. A review of the literature identified 19 allo-HCT recipients with coccidioidomycosis. Due to the limited published literature, no guidelines have yet been established regarding optimal prophylaxis and treatment of Coccidioides infection in allo-HCT recipients. Candidates for transplantation should undergo a rigorous pre-transplant assessment to identify evidence of prior or active coccidioidomycosis. In our experience, patients who visit or live in Coccidioides-endemic areas should receive primary prophylaxis for at least the first 100 days post-transplant, and duration should be extended as long as the patient remains on immunosuppression. Those with prior infection should receive secondary prophylaxis while immunosuppressed. Patients with active infection should have treatment and stabilization of infection and continue anti-fungal treatment through immunosuppression.
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spelling pubmed-81457582021-05-26 Coccidioidomycosis in Allogeneic Stem Cell Transplant Recipients: Case Series and Review of the Literature Saling, Christopher F. Gea-Banacloche, Juan Trickett, John S. Blair, Janis E. J Fungi (Basel) Case Report Coccidioides is an endemic fungus of the Southwest United States that causes the disease coccidioidomycosis. Immunocompromised persons are at increased risk for severe infection and dissemination. One such population is allogeneic bone marrow transplant (allo-HCT) recipients, but accounts of coccidioidal infection in these patients have rarely been documented. We present two cases of Coccidioides in allo-HCT recipients with good outcomes: one patient who developed pulmonary coccidioidomycosis in the late post-engraftment phase and another with known controlled disseminated infection at the time of transplant. A review of the literature identified 19 allo-HCT recipients with coccidioidomycosis. Due to the limited published literature, no guidelines have yet been established regarding optimal prophylaxis and treatment of Coccidioides infection in allo-HCT recipients. Candidates for transplantation should undergo a rigorous pre-transplant assessment to identify evidence of prior or active coccidioidomycosis. In our experience, patients who visit or live in Coccidioides-endemic areas should receive primary prophylaxis for at least the first 100 days post-transplant, and duration should be extended as long as the patient remains on immunosuppression. Those with prior infection should receive secondary prophylaxis while immunosuppressed. Patients with active infection should have treatment and stabilization of infection and continue anti-fungal treatment through immunosuppression. MDPI 2021-04-27 /pmc/articles/PMC8145758/ /pubmed/33925759 http://dx.doi.org/10.3390/jof7050339 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Saling, Christopher F.
Gea-Banacloche, Juan
Trickett, John S.
Blair, Janis E.
Coccidioidomycosis in Allogeneic Stem Cell Transplant Recipients: Case Series and Review of the Literature
title Coccidioidomycosis in Allogeneic Stem Cell Transplant Recipients: Case Series and Review of the Literature
title_full Coccidioidomycosis in Allogeneic Stem Cell Transplant Recipients: Case Series and Review of the Literature
title_fullStr Coccidioidomycosis in Allogeneic Stem Cell Transplant Recipients: Case Series and Review of the Literature
title_full_unstemmed Coccidioidomycosis in Allogeneic Stem Cell Transplant Recipients: Case Series and Review of the Literature
title_short Coccidioidomycosis in Allogeneic Stem Cell Transplant Recipients: Case Series and Review of the Literature
title_sort coccidioidomycosis in allogeneic stem cell transplant recipients: case series and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145758/
https://www.ncbi.nlm.nih.gov/pubmed/33925759
http://dx.doi.org/10.3390/jof7050339
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