Stealthy Pathogens & Blind Alleys

An interesting paper highlighting the ability of the relatively rare pathogens called Microsporida to exploit organ transplantation and the consequent immunosuppression was published in Annals of Internal Medicine

The case centers on a donor, originally from Mexico who asymptomatically harbored the Microsporida, died, and had her kidneys and lungs harvested and transplanted into 3 individuals. These individuals all developed symptoms consistent with infection and had extensive evaluations. Because the donor was suspected to have eaten unpasteurized cheese, another rare pathogen--Brucella--was considered and tests were positive in the recipients. However, treatment for Brucella did not improve the patients' conditions. Eventually, the correct diagnosis was arrived at and treated.

This case illustrates something awesome about infectious diseases--all the detective work, blind alleys, and false leads involved in making the correct diagnosis. 

In this case you have 3 organ transplant patients sick with something possibly donor derived. The donor is from Mexico and may have eaten unpasteurized cheese, a known risk factor for brucellosis. But, she turned out to have acquired Microsporidia which she likely acquired from exposure to animal excretions. 

The editorial that accompanies the paper talks of stealthy and unexpected pathogens that accompany transplanted organs. Wouldn't it be cool to have special eyes to see these things, sort of how antibodies are likened to soldiers with special vision in my favorite children's book