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Case Reports in Infectious Diseases
Volume 2015, Article ID 925718, 5 pages
http://dx.doi.org/10.1155/2015/925718
Case Report

Respiratory Failure due to Possible Donor-Derived Sporothrix schenckii Infection in a Lung Transplant Recipient

1Division of Infectious Disease and International Medicine, Department of Medicine, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 250, Minneapolis, MN 55455, USA
2Department of Medicine, University of Minnesota, 401 East River Parkway, VCRC 1st Floor, Suite 131, Minneapolis, MN 55455, USA
3Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 276, Minneapolis, MN 55455, USA
4Division of Cardiothoracic Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, Mayo Mail Code 207, Minneapolis, MN 55455, USA

Received 1 October 2015; Accepted 22 November 2015

Academic Editor: Paola Di Carlo

Copyright © 2015 Nathan C. Bahr et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. De novo and donor-derived invasive fungal infections (IFIs) contribute to morbidity and mortality in solid organ transplant (SOT) recipients. Reporting of donor-derived IFIs (DDIFIs) to the Organ Procurement Transplant Network has been mandated since 2005. Prior to that time no systematic monitoring of DDIFIs occurred in the United States. Case Presentation. We report a case of primary graft dysfunction in a 49-year-old male lung transplant recipient with diffuse patchy bilateral infiltrates likely related to pulmonary Sporothrix schenckii infection. The organism was isolated from a bronchoalveolar lavage on the second day after transplantation. Clinical and radiographic responses occurred after initiation of amphotericin B lipid formulation. Conclusion. We believe that this was likely a donor-derived infection given the early timing of the Sporothrix isolation after transplant in a bilateral single lung transplant recipient. This is the first case report of sporotrichosis in a lung transplant recipient. Our patient responded well to amphotericin induction therapy followed by maintenance therapy with itraconazole. The implications of donor-derived fungal infections and Sporothrix in transplant recipients are reviewed. Early recognition and management of these fungi are essential in improving outcomes.