Donor-related coccidioidomycosis in organ transplant recipients

Most cases of coccidioidomycosis in organ transplant recip-ients arise from either primary infection with Coccidioides immitis after environmental exposure or from reactivation of latent infection. Herein, we report 2 cases of rapidly fatal, disseminated coccidioidomycosis that occurred in organ transplant recipients who had never lived in or visited an area where C. immitis is endemic. Both subjects had received a transplanted organ from the same donor, an individual with unrecognized active coccidioidomycosis at the time of his death. Coccidioidomycosis is a systemic fungal infection caused by the dimorphic fungus Coccidioides immitis, which is endemic in the southwestern United States, northern Mexico, and parts of Cen-tral and South America. Primary infection with C. immitis is often asymptomatic but may cause a self-limited influenza-lik