ABSTRACT
The endemic mycoses cause a relatively small number of infections in solid organ transplant recipients. This is partly because these fungi are restricted geographically; a patient must come into contact with the organism in the environment. This exposure can be immediately before the infection develops in the case of new-onset infection or decades earlier with reactivation infection. The endemic fungi, especially Histoplasma capsulatum, have the ability to remain dormant in the body for years; when immunosuppression occurs in the course of transplantation, the organisms begin to proliferate and cause reactivation disease. Rarely, infection can develop in a transplant recipient who has received a donor organ that contains one of the endemic fungi.
