Transmission of Balamuthia mandrillaris by Organ Transplantation.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Farnon Eileen C, Kokko Kenneth E, Budge Philip J, Mbaeyi Chukwuma, Lutterloh Emily C, Qvarnstrom Yvonne, da Silva Alexandre J, Shieh Wun-Ju, Roy Sharon L, Paddock Christopher D, Sriram Rama, Zaki Sherif R, Visvesvara Govinda S, Kuehnert Matthew J, Balamuthia Transplant Investigation Teams, Weiss Joli, Komatsu Ken, Manch Richard, Ramos Alberto, Echeverria Leonor, Moore Ann, Zakowski Phil, Kittleson Michelle, Kobashigawa Jon, Yoder Jonathan, Beach Michael, Mahle William, Kanter Kirk, Geraghty P J, Navarro Eileen, Hahn Christine, Fujita Shiro, Stinson Jim, Trachtenberg Joel, Byers Paul, Cheung Michele, Jie Tun, Kaplan Bruce, Gruessner Rainer, Bracamonte Erica, Viscusi Chad, Gonzalez-Peralta Regino, Lawrence Robert, Fratkin Jonathan, Butt Fauzia
Аннотация
METHODS: We investigated all recipients and the 2 donors through interview, medical record review, and testing of available specimens retrospectively. Surviving recipients were tested and treated prospectively.
RESULTS: In the 2009 cluster of illness, 2 kidney recipients were infected and 1 died. The donor had Balamuthia encephalitis confirmed on autopsy. In the 2010 cluster, the liver and kidney-pancreas recipients developed Balamuthia encephalitis and died. The donor had a clinical syndrome consistent with Balamuthia infection and serologic evidence of infection. In both clusters, the 2 asymptomatic recipients were treated expectantly and survived; 1 asymptomatic recipient in each cluster had serologic evidence of exposure that decreased over time. Both donors had been presumptively diagnosed with other neurologic diseases prior to organ procurement.
CONCLUSIONS: Balamuthia can be transmitted through organ transplantation with an observed incubation time of 17-24 days. Clinicians should be aware of Balamuthia as a cause of encephalitis with high rate of fatality, and should notify public health departments and evaluate transplant recipients from donors with signs of possible encephalitis to facilitate early diagnosis and targeted treatment. Organ procurement organizations and transplant centers should be aware of the potential for Balamuthia infection in donors with possible encephalitis and also assess donors carefully for signs of neurologic infection that may have been misdiagnosed as stroke or as noninfectious forms of encephalitis.