Treatment of Acute Pulmonary Coccidioidomycosis in Hematopoietic Stem Cell or Solid Organ Transplant Recipients

This protocol addresses acute pulmonary coccidioidomycosis in recipients of autologous or allogeneic hematopoietic stem cell transplant (HSCT) or solid organ transplant who present in a clinically stable condition with normal renal function.

Clinical Scenario

The patient is an autologous or allogeneic HSCT recipient, or a solid organ transplant recipient, with acute pulmonary coccidioidomycosis. Qualifying criteria for this protocol: clinically stable status and normal renal function.

Treatment Approach

For this population, an oral antifungal agent is initiated as first-line therapy, with dosing adapted to renal function status. The specific agent, dose, and complete regimen are available in the full structured protocol.

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References

DOI: 10.1093/cid/ciw360

For the treatment of autologous or allogeneic HSCT or solid organ transplant recipients with acute or chronic pulmonary coccidioidomycosis who are clinically stable and have normal renal function, we recommend initiating treatment with fluconazole 400 mg daily or the equivalent dose based upon renal function (strong, low).

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