title: Incidence and clinical predictors of primary opportunistic deep cutaneous mycoses in solid organ transplant recipients: a multicenter cohort study.
abstract: BACKGROUND
  Primary opportunistic deep cutaneous fungal infections may cause significant morbidity and mortality in solid organ transplant recipients (OTR), but no data exist about their incidence, timing, and clinical predictors in a long-term follow-up.
  
  
  METHODS
  A series of 3293 consecutive OTR including 1991 kidney, 929 heart, and 373 liver transplant recipients were enrolled. Patients were regularly followed up since time at transplantation (mean 5.5 yr +/-5.9 SD) and primary opportunistic fungal infections registered. Persons-year at risk (PYs), incidence rates (IR), incidence rate ratios (IRR), and 95% confidence intervals were computed.
  
  
  RESULTS
  Twenty-two cases of deep cutaneous mycoses were detected, (IR 1.2 cases per 1000 PYs) after a mean follow-up time since transplantation of 2.5 yr +/- 2.0 SD (median 1.8 yr). Six patients had subsequent systemic involvement and three patients died of systemic dissemination. A higher risk for mycoses was observed in the first two yr after transplantation, (IRR 35.9, p < 0.0001), in renal transplant recipients (IRR 5.1 p = 0.030), and in patients transplanted after the age of 50 (IRR 11.5 p = 0.020).
  
  
  CONCLUSIONS
  Primary deep cutaneous opportunistic mycoses in OTR occur mainly in the first two yr after transplantation, in renal transplant recipients, and in older patients.
authors.affiliation: Section of Dermatology, University of Verona, 10032 Verona, Italy. gianpaolo.tessari@azosp.vr.it
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Tessari
authors.forename: Luigi
authors.initials: L
authors.lastname: Naldi
authors.forename: Stefano
authors.initials: S
authors.lastname: Piaserico
authors.forename: Luigino
authors.initials: L
authors.lastname: Boschiero
authors.forename: Francesco
authors.initials: F
authors.lastname: Nacchia
authors.forename: Alberto
authors.initials: A
authors.lastname: Forni
authors.forename: Carlo
authors.initials: C
authors.lastname: Rugiu
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Faggian
authors.forename: Elena
authors.initials: E
authors.lastname: Dall'olio
authors.forename: Anna Belloni
authors.initials: AB
authors.lastname: Fortina
authors.forename: Mauro
authors.initials: M
authors.lastname: Alaibac
authors.forename: Fabrizia
authors.initials: F
authors.lastname: Sassi
authors.forename: Eliana
authors.initials: E
authors.lastname: Gotti
authors.forename: Roberto
authors.initials: R
authors.lastname: Fiocchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Fagioli
authors.forename: Giampiero
authors.initials: G
authors.lastname: Girolomoni
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003881:Dermatomycoses / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors