COCCIDIOIDOMYCOSIS AND RENAL TRANSPLANTATION

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Abstract
Cases (2) of coccidioidomycosis detected in a group of more than 750 renal transplants are presented. The 1st patient died from unsuspected disseminated coccidioidomycosis 4 1/2 yr after primary transplantation and 6 days after retransplantation. In the 2nd patient pulmonary coccidioidomycosis was recognized and treated by lobectomy and amphotericin B before transplantation; subsequent transplantation provided good renal function without recurrence of infection for 5 yr. Experience with 6 other reported cases of coccidioidomycosis illustrates the high risk of exacerbation and dissemination of preexisting coccidioidal infection in immunosuppressed transplant recipients. This risk can be made acceptable if active coccidioidomycosis is treated vigorously before immunosuppression is started and if the possibility of exacerbation of infection after transplantation is carefully monitored.

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