Prevention and Treatment of Other Opportunistic Infections: Nocardiosis, Toxoplasmosis, Chagas and Pneumocystis Disease

Solid organ transplant recipients are susceptible to a wide array of opportunistic infections. In this chapter we will focus on some of the more uncommon infectious diseases—nocardiosis, toxoplasmosis, pneumocystis, and Chagas disease. Given the generally low incidence yet deadly outcomes in transplant recipients, it is important for transplant professionals to be aware of assessing epidemiologic risk (particularly in Chagas disease), clinical presentation, and prevention strategies that we can employ. Donor-derived infections may occur in the case of toxoplasmosis and Chagas disease, and it is important to consider these early—patients may not be considered typical hosts, and other organ recipients may also be at risk. Many of these organisms may not be easily identified under standard microbiologic methods. As new methods evolve, it is important for us to keep abreast of these. Finally, once identified, we will review some of the best treatment regimens.