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Coccidioidomycosis is an infection due to the fungal species Coccidioides, which is most heavily endemic in the desert southwestern USA. Although early studies of this infection among transplant recipients in the endemic region were complicated by high morbidity and mortality, solid organ and hematologic stem cell transplantation can be a successful undertaking within the Coccidioides-endemic region. Such success has been attributed to careful attention to screening for and treatment of occult infection prior to transplantation. Antifungal prophylaxis is important to prevent new acquisition or reactivation in the first year following transplantation. Prophylaxis strategies have undergone study and revision and should target the prevention of coccidioidomycosis in the first post-transplantation year, after acute organ rejection, and in recipients of Coccidioides-infected donors. Early recognition and treatment of organ recipients with acute coccidioidomycosis is key to minimizing morbidity and mortality. Diagnostic studies early in the course of infection can be insensitive, but sensitivity improves with repeated testing. Prevention and treatment strategies are reviewed and presented herein.

DOI: 10.1007/978-3-030-01751-4_49-1