Safety and efficacy of chronic suppressive azole therapy for endemic fungal infections in solid organ transplant recipients

Trinh, Sonya; Echenique, Ignacio A.; Penugonda, Sudhir; Angarone, Michael

doi:10.1111/tid.12963

Cited by 8 publications

(3 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We screened 548 studies, of which 197 fulfilled criteria [ 2–197 ]. Of these, 4 included a review of related literature [ 2–4 , 198 ], 15 were cohort studies [ 10 , 32 , 47 , 53 , 54 , 56 , 57 , 62 , 63 , 71 , 89 , 100 , 184 , 185 , 187 ], and the majority were case reports. After careful review of references, 1 cohort [ 1 ] and 42 additional case reports or series were identified [ 199–213 ] including 20 [ 188 , 190 , 192 , 214–230 ] from a prior review [ 4 ].…”

Section: Resultsmentioning

confidence: 99%

“…Among 16 cohort studies, 3 reported on blastomycosis [ 56 , 62 , 63 ], 5 on coccidioidomycosis [ 10 , 32 , 47 , 53 , 71 ], and 4 on histoplasmosis [ 1 , 54 , 89 , 248 ], and 4 evaluated a mixture of endemic mycoses [ 57 , 184 , 185 , 187 ]. The majority of cohorts were single-institution studies, except for 4 [ 47 , 57 , 184 , 185 ] that involved multiple institutions and included surveillance data [ 184 ], or registry data [ 185 ].…”

Section: Resultsmentioning

confidence: 99%

“…The 4 remaining studies looked at a mixture of different infections [ 57 , 184 , 185 , 187 ]. A summary of these studies is in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Characteristics and Outcomes of Endemic Mycoses After Solid Organ Transplantation: A Comprehensive Review

Abad,

Razonable

2024

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Background Geographically endemic fungi can cause significant disease among solid organ transplant (SOT) recipients. We provide an update on the epidemiology, clinical presentation and outcomes of 5 endemic mycoses in SOT recipients. Methods Multiple databases were reviewed from inception through May 2023 using key words for endemic fungi (e.g. Coccidioidomycosis or Coccidioides, Histoplasmosis or histoplasma, etc.). We included adult SOT recipients and publications in English or with English translation. Results Among 16 cohort studies that reported on blastomycosis (n=3), coccidioidomycosis (n=5), histoplasmosis (n=4), and various endemic mycoses (n=4), the incidence rates varied: coccidioidomycosis (1.2-5.8%); blastomycosis (0.14-0.99%) and histoplasmosis (0.4-1.1%). There were 204 reports that described 268 unique cases of endemic mycoses, including 172 histoplasmosis, 31 blastomycosis, 34 coccidioidomycosis, 6 paracoccidioidomycosis, and 25 talaromycosis. The majority of patients were male (176/261, 67.4%). Transplanted allografts were mostly kidney (191/268, 71.3%), followed by liver (n=39, 14.6%), heart (n=18, 6.7%), lung (n=13, 4.9%), combined kidney-liver, and kidney-pancreas (n=6, 2.7%). In all five endemic mycoses, most patients presented with fever (162/232, 69.8%) and disseminated disease (179/268, 66.8%). Cytopenias were frequently reported for histoplasmosis (71/91, 78.0%), coccidioidomycosis (8/11, 72.7%) and talaromycosis (7/8, 87.5%). Graft loss was reported in 12/136 patients (8.8%). All-cause mortality was reported in 71/267 (26.6%); half (n=34, 50%) of the deaths were related to the underlying mycoses. Conclusions Endemic mycoses commonly present with fever, cytopenias and disseminated disease in SOT recipients. There is a relatively high rate of all-cause mortality, including many that were attributed to endemic mycoses.

show abstract