Transplant Recipients Contracted Microsporidiosis From Donor Interview with:
Dr. Susan N. Hocevar MD
Centers for Disease Control and Prevention
Atlanta, GA 30333;  What are the main findings of the study?

Dr. Hocevar: This public health investigation uncovered microsporidiosis transmitted to 3 organ recipients who received organs from a common donor. This illness cluster was the first recognized occurrence of donor-derived microsporidiosis.  Were any of the findings unexpected?

Dr. Hocevar: The diagnosis of microsporidiosis in all 3 organ recipients was surprising. The organ donor was asymptomatic at the time of organ procurement and risk factors or symptoms consistent with microsporidiosis were not reported on follow up questioning of the donor’s family. Despite lack of symptoms, the donor had elevated serum titers against the organism suggesting asymptomatic infection.  What should clinicians and patients take away from your report?

Dr. Hocevar:  Physicians should consider donor derived disease in their transplant recipients. If donor derived disease is suspected, reporting to the organ procurement organization will aid in recognition of illness clusters and, when a specific organism is identified, may aid in the therapy of other organ recipients who received organs from the same donor. Infection with microsporidia may be asymptomatic and more common than we think.  What recommendations do you have for future research as a result of this study?

Dr. Hocevar:  The diagnosis of microsporidiosis requires a high index of suspicion and can be difficult to make. Microsporidiosis should be considered in the differential diagnosis especially when other, more commonly encountered illnesses have been ruled out or when recipients are poorly responsive to therapy.


Microsporidiosis Acquired Through Solid Organ Transplantation: A Public Health Investigation

Susan N. Hocevar, MD; Christopher D. Paddock, MD; Cedric W. Spak, MD; Randall Rosenblatt, MD; Hector Diaz-Luna, MD; Isabel Castillo, RN, BSN; Sergio Luna, RN; Glen C. Friedman, MD; Suresh Antony, MD; Robyn A. Stoddard, DVM, PhD; Rebekah V. Tiller, MPH; Tammie Peterson, RN, MSN/MPH, CPTC; Dianna M. Blau, DVM, PhD; Rama R. Sriram, BS; Alexandre da Silva, PhD; Marcos de Almeida, PhD; Theresa Benedict, BS; Cynthia S. Goldsmith, MGS; Sherif R. Zaki, MD, PhD; Govinda S. Visvesvara, PhD; Matthew J. Kuehnert, MD, for the Microsporidia Transplant Transmission Investigation Team*

Ann Intern Med. 2014;160(4):213-220-220. doi:10.7326/M13-2226




Microsporidiosis Acquired Through Solid Organ Transplantation: A Public Health Investigation

Susan N. Hocevar, Christopher D. Paddock, Cedric W. Spak, Randall Rosenblatt, Hector Diaz-Luna, Isabel Castillo, Sergio Luna, Glen C. Friedman, Suresh Antony, Robyn A. Stoddard, Rebekah V. Tiller, Tammie Peterson, Dianna M. Blau, Rama R. Sriram, Alexandre da Silva, Marcos de Almeida, Theresa Benedict, Cynthia S. Goldsmith, Sherif R. Zaki, Govinda S. Visvesvara, Matthew J. Kuehnert, for the Microsporidia Transplant Transmission Investigation Team; Microsporidiosis Acquired Through Solid Organ TransplantationA Public Health Investigation. Annals of Internal Medicine. 2014 Feb;160(4):213-220.

Last Updated on December 21, 2014 by Marie Benz MD FAAD