Coccidioidomycosis in liver transplant patients

Curtis D. Holt, Drew J. Winston, Bernard Kubak, David K. Imagawa, Paul Martin, Leonard Goldstein, Kim Olthoff, J. Michael Millis, Abraham Shaked, Christopher R. Shackleton, Ronald W. Busuttil

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Eight (0.59%) of 1,347 patients who underwent liver transplantation at the UCLA Medical Center (Los Angeles) developed coccidioidomycosis. Whereas only one case occurred during the first 8 years and 10 months of the UCLA Liver Transplant Program (February 1984 to December 1992), seven cases occurred within the following 23-month period (December 1992 to November 1994). The median time of onset for infection after transplantation was 8 weeks (range, 4-312 weeks). Clinical presentations of patients with coccidioidomycosis included pneumonia (six cases), pneumonia with meningitis (one case), hepatitis (one case), and monoarticular arthritis (one case). Despite therapy with amphotericin B alone (six cases) or amphotericin B plus fluconazole (two cases), infection was fatal in four of eight cases. As of this writing, the four surviving patients are receiving chronic maintenance therapy with either fluconazole (three patients) or itraconazole (one patient). These experiences show that coccidioidomycosis can be a serious and frequently fatal infection after liver transplantation and that the incidence of this disease appears to be increasing.

Original languageEnglish
Pages (from-to)216-221
Number of pages6
JournalClinical Infectious Diseases
Volume24
Issue number2
StatePublished - Feb 27 1997
Externally publishedYes

Fingerprint

Coccidioidomycosis
Transplants
Liver
Fluconazole
Amphotericin B
Liver Transplantation
Pneumonia
Infection
Itraconazole
Los Angeles
Meningitis
Hepatitis
Arthritis
Transplantation
Incidence
Therapeutics

ASJC Scopus subject areas

  • Immunology

Cite this

Holt, C. D., Winston, D. J., Kubak, B., Imagawa, D. K., Martin, P., Goldstein, L., ... Busuttil, R. W. (1997). Coccidioidomycosis in liver transplant patients. Clinical Infectious Diseases, 24(2), 216-221.

Coccidioidomycosis in liver transplant patients. / Holt, Curtis D.; Winston, Drew J.; Kubak, Bernard; Imagawa, David K.; Martin, Paul; Goldstein, Leonard; Olthoff, Kim; Michael Millis, J.; Shaked, Abraham; Shackleton, Christopher R.; Busuttil, Ronald W.

In: Clinical Infectious Diseases, Vol. 24, No. 2, 27.02.1997, p. 216-221.

Research output: Contribution to journalArticle

Holt, CD, Winston, DJ, Kubak, B, Imagawa, DK, Martin, P, Goldstein, L, Olthoff, K, Michael Millis, J, Shaked, A, Shackleton, CR & Busuttil, RW 1997, 'Coccidioidomycosis in liver transplant patients', Clinical Infectious Diseases, vol. 24, no. 2, pp. 216-221.
Holt CD, Winston DJ, Kubak B, Imagawa DK, Martin P, Goldstein L et al. Coccidioidomycosis in liver transplant patients. Clinical Infectious Diseases. 1997 Feb 27;24(2):216-221.
Holt, Curtis D. ; Winston, Drew J. ; Kubak, Bernard ; Imagawa, David K. ; Martin, Paul ; Goldstein, Leonard ; Olthoff, Kim ; Michael Millis, J. ; Shaked, Abraham ; Shackleton, Christopher R. ; Busuttil, Ronald W. / Coccidioidomycosis in liver transplant patients. In: Clinical Infectious Diseases. 1997 ; Vol. 24, No. 2. pp. 216-221.
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