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Donor-derived disease is an uncommon but well-characterized consequence of solid organ transplantation (SOT). As the process of procuring organs from deceased donors is necessarily time limited, routine screening tests include blood, urine, and sputum cultures and molecular testing for certain bloodborne viral pathogens (e.g., HIV); also, a good history of the donor is critically important. Testing for more-exotic pathogens is not commonly performed. When recipients develop difficult-to-diagnose conditions, risk factors for disease acquisition from donors should be considered. Bartonella quintana is transmitted by body lice and thus more commonly found among individuals in highly disadvantaged settings. Infection with this pathogen causes r…