Donor-derived Scedosporium infection following deceased donor kidney transplantation presenting as endogenous endophthalmitis.

PURPOSE: To describe a novel case of donor-derived scedosporium infection following kidney transplantation presenting as endogenous endophthalmitis.

OBSERVATIONS: A 69 year-old male presented with right eye pain and redness for 3 days following deceased donor kidney transplant one month prior. Initial exam showed counting fingers vision, 4+ anterior chamber cell, hypopyon, dense vitritis, and a large white macular lesion. A vitreous tap and inject was performed with intravitreal vancomycin, ceftazidime, and voriconazole. The patient was admitted to the for systemic antimicrobials where infectious workup revealed a psoas abscess and a perinephric donor kidney fluid collection with biopsy of the fluid yielding positive Scedosporium spp. Given his multifocal systemic infection, recent transplantation, and immunosuppression requirements, a review of the donor history was performed and revealed evidence of systemic Scedosporium infection. A diagnosis of donor-derived Scedosporium infection was made. The other transplant centers where the other organs from this donor were used were contacted and each of their recipients were screened, however, no other donor-derived infections were found.

CONCLUSIONS AND

IMPORTANCE

Donor derived scedosporium infections can have devastating ophthalmologic and systemic complications in solid organ transplant recipients. Further efforts are warranted to better screen for the risk for deceased donor fungal infections during transplant organ evaluation.