Donor-derived Cryptococcus gattii sensu stricto infection in two kidney transplant recipients, southeastern United States

Pavithra Natarajan, Shawn R. Lockhart, Sridhar V. Basavaraju, Shweta Anjan, Mark D. Lindsley, Martina M. McGrath, David H. Oh, Brendan R. Jackson

Research output: Contribution to journalArticlepeer-review

Abstract

Cryptococcus gattii infection is a rare cause of severe pulmonary disease and meningoencephalitis that has only recently been detected in the southeastern United States. We describe an organ transplant-associated outbreak of C. gattii infection involving an HIV-negative immunosuppressed donor in this region who died following new-onset headache and seizure of unknown cause. Retrospective cryptococcal antigen (CrAg) testing of donor serum was positive. Two of the three transplant recipients developed severe C. gattii infection 11 and 12 weeks following transplantation. One recipient died from severe pulmonary infection, identified on autopsy, and the other ill recipient survived following treatment for cryptococcal meningitis. This outbreak underscores the importance of considering cryptococcosis in patients with clinical findings suggestive of subacute meningitis or other central nervous system (CNS) pathology, and the potential benefit of routine pre-transplant donor CrAg screening using lateral flow assay to guide recipient antifungal prophylaxis. The case also adds to emerging evidence that C. gattii is a potential threat in the southeastern United States.

Original languageEnglish (US)
Pages (from-to)3780-3784
Number of pages5
JournalAmerican Journal of Transplantation
Volume21
Issue number11
DOIs
StatePublished - Nov 2021

Keywords

  • clinical research/practice
  • infection and infectious agents
  • infection and infectious agents – fungal
  • infectious disease
  • kidney transplantation/nephrology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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