ABSTRACT
BACKGROUND: Updating live vaccines such as measles, mumps, rubella, and varicella (MMRV) is an important step in preparing patients for solid organ transplant (SOT) to prevent morbidity from these preventable diseases. However, data for this approach are scarce. Thus, we aimed to describe the seroprevalence of MMRV and the efficacy of the vaccines in our transplant center. METHODS: Pre-SOT candidates >18 y of age were retrospectively retrieved from SOT database in Memorial Hermann Hospital Texas Medical Center. MMRV serologies are routinely screened at the time of pretransplant evaluation. We divided patients into 2 groups: MMRV-positive group versus MMRV-negative group, patients with positive all MMRV serologies and with negative immunity to at least 1 dose of MMRV, respectively. RESULTS: A total of 1213 patients were identified. Three hundred ninety-four patients (32.4%) did not have immunity to at least 1 dose of MMRV. Multivariate analysis was conducted. Older age (odds ratio [OR]: 1.04) and liver transplant candidates (OR: 1.71) were associated with seropositivity. Previous history of SOT (OR: 0.54) and pancreas/kidney transplant candidates (OR: 0.24) were associated with seronegativity. Among 394 MMRV seronegative patients, 60 patients received 1 dose of MMR vaccine and 14 patients received 1 dose of varicella-zoster virus vaccine without severe adverse events. A total of 35% (13/37) of patients who had follow-up serologies did not have a serological response. CONCLUSIONS: A significant number of pre-SOT candidates were not immune to at least 1 dose of MMRV. This highlights the importance of MMRV screening and vaccinations pre-SOT. Postvaccination serological confirmation should be performed to evaluate the necessity for a second dose.
Subject(s)
Chickenpox , Measles , Mumps , Organ Transplantation , Rubella , Humans , Adult , Infant , Herpesvirus 3, Human , Mumps/diagnosis , Mumps/epidemiology , Mumps/prevention & control , Seroepidemiologic Studies , Retrospective Studies , Vaccines, Combined/adverse effects , Measles/epidemiology , Measles/prevention & control , Rubella/epidemiology , Rubella/prevention & control , Rubella/chemically induced , Chickenpox Vaccine , Chickenpox/prevention & control , Vaccination , Organ Transplantation/adverse effects , Antibodies, ViralSubject(s)
COVID-19/diagnosis , Mass Screening , Telemetry , Thermography , Body Temperature , COVID-19/epidemiology , COVID-19/prevention & control , Dimensional Measurement Accuracy , Humans , Mass Screening/instrumentation , Mass Screening/methods , Remote Sensing Technology , Reproducibility of Results , SARS-CoV-2 , Telemetry/instrumentation , Telemetry/methods , Tertiary Care Centers , Texas , Thermography/instrumentation , Thermography/methodsSubject(s)
Diabetes Complications/microbiology , Mucormycosis/pathology , Aged , Antifungal Agents/therapeutic use , Diagnosis , Diagnosis, Differential , Fatal Outcome , Female , Humans , Mucormycosis/diagnosis , Opportunistic Infections/diagnosis , Opportunistic Infections/pathology , Pancreatic Neoplasms/diagnosis , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/microbiologyABSTRACT
Histoplasma capsulatum is a dimorphic endemic fungus which infects both immunocompetent and immunocompromised hosts. Isolated CNS histoplasmosis is a rare presentation with increased risk in individuals with impaired cellular immunity, however not all patients with this condition are immunocompromised. We report a case of isolated CNS histoplasmosis in an otherwise healthy immunocompetent patient who was initially treated with Liposomal Amphotericin B followed by oral Voriconazole and later Itraconazole with significant improvement in clinical status.