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Organ Transplant Patients and Fungal Infections

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As an organ transplant patient, you have new opportunities for a healthy and full life. You may also have some new health challenges. One of those challenges is avoiding infections. While anti-rejection medication helps your accept the new organ by lowering your body’s immune system response, it can also put you at greater risk for fungal infections.

 

What you need to know about fungal infections

Fungal infections can range from mild to life-threatening. Some fungal infections are mild skin rashes, but others can be deadly, like fungal pneumonia. Because of this, it’s important to seek treatment as soon as possible to try to avoid serious infection.

Fungal infections can look like bacterial or viral infections. If you’re taking medicine to fight a bacterial or viral infection and you aren’t getting better, ask your doctor about testing you for a fungal infection.

Fungal infections may be more common in certain types of transplants. Some experts think that fungal infections may be most common in small bowel transplant patients, followed by lung, liver, and heart transplant patients.1

Where you live (geography) matters. Some disease-causing fungi are more common in certain parts of the world. If you have had an organ transplant and live in or visit these areas, you’re more likely to get these infections than the general population.2 For more information on travel-related illnesses, please see the CDC Traveler’s Health site.

Your hospital stay matters. After your transplant, you may need to stay in the hospital for a long time. While there, you may need procedures that can increase your chance of getting a fungal infection. Please see types of hospital-associated infections for more information.

Fungal infections can happen any time after your surgery. Fungal infections can happen days, weeks, months, or years after the transplant surgery.3

Some types of fungal infections are more common than others in solid organ transplant patients. In the United States, invasive candidiasis is most common, followed by aspergillosis and cryptococcosis, but other types of fungal infections are also possible.1 For lung transplant patients, aspergillosis is most common.1,4

Indoor mold. You may be at higher risk for getting sick from indoor mold. For more information about indoor mold, please visit CDC's Basic Facts about Mold page.

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Preventing fungal infections in organ transplant patients

Fungi are difficult to avoid because they are a natural part of the environment. Fungi live outdoors in soil, on plants, trees, and other vegetation. They are also on many indoor surfaces and on your skin. However, there may be some ways you to lower your chance of getting a serious fungal infection.

Learn about fungal infections. There are different types of fungal infections. Learning about them can help you and your healthcare provider recognize the symptoms early, which may prevent serious illness.

Get additional medical care if necessary. Fungal infections often resemble other illnesses. Visiting your healthcare provider may help with faster diagnosis and may prevent serious illness.

Antifungal medication. Your healthcare provider may prescribe medication to prevent fungal infections. Scientists are still learning about which transplant patients are at highest risk and how to best prevent fungal infections.5

Protect yourself from the environment. As you recover from your surgery and start doing your normal activities again, there may be some ways to lower your chances of getting a serious fungal infection by trying to avoid disease-causing fungi in the environment.6  It’s important to note that although these actions are recommended, they have not been proven to prevent fungal infections.

  • Try to avoid areas with a lot of dust like construction or excavation sites.
  • Stay inside during dust storms.
  • Stay away from areas with bird and bat droppings. This includes places like chicken coops and caves.
  • Wear gloves when handling materials such as soil, moss, or manure.
  • Wear shoes, long pants, and a long-sleeved shirt when doing outdoor activities such as gardening, yard work, or visiting wooded areas.

References

  1. Pappas PG, Alexander BD, Andes DR, et al. Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET). Clinical Infectious Diseases 2010;50:1101-11.
  2. Miller R, Assi M, Practice ASTIDCo. Endemic fungal infections in solid organ transplantation. American Journal of Transplantation 2013;13 Suppl 4:250-61.
  3. Shoham S, Marr KA. Invasive fungal infections in solid organ transplant recipients. Future Microbiology 2012;7:639-55.
  4. Neofytos D, Fishman JA, Horn D, et al. Epidemiology and outcome of invasive fungal infections in solid organ transplant recipients. Transplant Infectious Disease 2010;12:220-9.
  5. Brizendine KD, Vishin S, Baddley JW. Antifungal prophylaxis in solid organ transplant recipients. Expert Review of Anti-infective Therapy 2011;9:571-81.
  6. Avery RK, Michaels MG. Strategies for safe living after solid organ transplantation. American Journal of Transplantation 2013;13 Suppl 4:304-10.

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