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Chapter 37 : Cryptococcosis in Transplant Recipients
Authors:
Nina Singh1,
Barbara D. Alexander2
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Affiliations:
1: VA Pittsburgh Healthcare System and University of Pittsburgh, Pittsburgh, PA 15260;
2: Departments of Medicine and Pathology, Duke University Medical Center, Durham, NC 27710
Content Type: Monograph
Publication Year:
2011
Category: Clinical Microbiology; Fungi and Fungal Pathogenesis
Book DOI:
10.1128/9781555816858
Chapter DOI:
10.1128/9781555816858.ch37
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Abstract:
Cryptococcosis is one of the most significant opportunistic fungal infections in solid organ transplant (SOT) recipients. Disease presentation and principles of management of cryptococcosis in other hosts are relevant in transplant recipients. This chapter summarizes the current knowledge and topical developments in the epidemiologic characteristics, clinical manifestations, diagnosis, and management of cryptococcosis in transplant recipients. Cryptococcosis is the third most commonly occurring invasive fungal disease in SOT recipients. Most cryptococcal disease in SOT recipients is due to Cryptococcus neoformans var. grubii (serotype A), which has no particular geographic predilection. Calcineurin inhibitors are currently the mainstay of immunosuppression in SOT recipients. Cutaneous cryptococcosis can present as papular, nodular, or ulcerative lesions; cellulitis; or necrotizing fasciitis. While cutaneous lesions largely represent hematogenous dissemination, skin has also been identified as a portal of entry of Cryptococcus and a potential source of subsequent disseminated disease in SOT recipients. Rapid reduction of immunosuppressive therapy in conjunction with initiation of antifungal therapy in SOT recipients may lead to the development of immune reconstitution syndrome (IRS), the clinical manifestations of which mimic worsening disease due to cryptococcosis. Cryptococcosis occurs rarely in hematopoietic stem cell transplant (HSCT) recipients. Lipid formulations of amphotericin B are recommended in lieu of amphotericin B deoxycholate owing to the risk of nephrotoxicity when concurrently administered with a calcineurin inhibitor and owing to the significant number of transplant patients with underlying renal dysfunction at the time of diagnosis. Reduction in immunosuppressive therapy should be considered in transplant recipients diagnosed with cryptococcosis.
Citation:
Singh N, Alexander B.
2011.
Cryptococcosis in Transplant Recipients,
p 507-514.
In
Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed),
Cryptococcus.
ASM Press, Washington, DC.
doi: 10.1128/9781555816858.ch37
Key Concept Ranking
- Opportunistic Fungal Infections
- 0.5654973
- Cryptococcal Antigen Test
- 0.45551208
- Magnetic Resonance Imaging
- 0.4117915
0.5654973
Figures
Cryptococcosis in Transplant Recipients
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Citation:
Singh N, Alexander B.
2011.
Cryptococcosis in Transplant Recipients,
p 507-514.
In
Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed),
Cryptococcus.
ASM Press, Washington, DC.
doi: 10.1128/9781555816858.ch37
/content/10.1128/9781555816858.ch37.ch37fig01
FIGURE 1
(Top) Immunoblots of paired sera from SOT recipients (with blot on the left of each pair made with sera obtained pretransplant and blot on the right made with sera obtained at the diagnosis of posttransplant cryptococcosis) exhibited an increase in reactivity against nine designated proteins in association with cryptococcosis. (Bottom) The corresponding median number of designated proteins recognized by these paired sera is shown.
10.1128/9781555816858/f0508-01_thmb.gif
10.1128/9781555816858/f0508-01.gif
FIGURE 1
(Top) Immunoblots of paired sera from SOT recipients (with blot on the left of each pair made with sera obtained pretransplant and blot on the right made with sera obtained at the diagnosis of posttransplant cryptococcosis) exhibited an increase in reactivity against nine designated proteins in association with cryptococcosis. (Bottom) The corresponding median number of designated proteins recognized by these paired sera is shown.
Citation:
Singh N, Alexander B.
2011.
Cryptococcosis in Transplant Recipients,
p 507-514.
In
Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed),
Cryptococcus.
ASM Press, Washington, DC.
doi: 10.1128/9781555816858.ch37
References
/content/book/10.1128/9781555816858.ch37
1.
Anderson, D. J.,, C. Schmidt,, J. Goodman, and, C. Pomeroy. 1992. Cryptococcal disease presenting as cellulitis. Clin. Infect. Dis. 14: 666– 672.
2.
Baddley,, J. W.,, J. R. Perfect,, R. A. Oster,, R. A. Larson,, G. A. Pankey,, H. Henderson,, D. W. Haas,, C. A. Kauffman,, R. Patel,, A. K. Zaas, and, P. G. Pappas. 2008. Pulmonary cryptococccosis in patients without HIV infection: factors associated with disseminated disease. Eur. J. Clin. Microbiol. Infect. Dis. 27: 937– 943.
3.
Baker, R. D. 1976. The primary pulmonary lymph node complex of cryptococcosis. Am. J. Clin. Pathol. 65: 83– 92.
4.
Beyt, B. E., Jr., and, S. R. Waltman. 1978. Cryptococcal endophthalmitis after corneal transplantation. N. Engl. J. Med. 15: 825– 826.
5.
Biswas, J.,, L. Gopal,, T. Sharma,, S. Parikh,, H. N. Madhavan, and, S. S. Badrinath. 1998. Recurrent cryptococcal choroiditis in a renal transplant patient. Retina 18: 273– 276.
6.
Blankenship, J. R.,, N. Singh,, B. D. Alexander, and, J. Heitman. 2005. Cryptococcus neoformans isolates from transplant recipients are not selected for resistance to calcineurin inhibitors by current immunosuppressive regimens. J. Clin. Microbiol. 43: 464– 467.
7.
Brouwer,, A. E.,, A. Rajanuwong,, W. Chierakul,, G. E. Griffin,, R. A. Larsen,, N. J. White, and, T. S. Harrison. 2004. Combination antifungal therapies for HIV-associated cryptococcal meningitis: a randomised trial. Lancet 363: 1764– 1767.
8.
Bruno,, K. M.,, L. Farhoomand,, B. S. Libman,, C. N. Pappas, and, F. J. Landry. 2002. Cryptococcal arthritis, tendinitis, tenosynovitis, and carpal tunnel syndrome: report of a case and review of the literature. Arthritis Care Res. 47: 104– 108.
9.
Casadevall, A. 2004. What is the latest approach to pulmonary cryptococcosis. J. Respir. Dis. 25: 188– 199.
10.
Casadevall, A., and, L. A. Pirofski. 2003. The damageresponse framework of microbial pathogenesis. Nat. Rev. Microbiol. 1: 17– 24.
11.
Charlier,, C., F. Dromer,, C. Leveque,, L. Chartier,, Y. S. Cordoliani,, A. Fontanet,, O. Launay,, O. Lortholary, and French Cryptococcosis Study Group. 2008. Cryptococcal neuroradiological lesions correlate with severity during cryptococcal meningoencephalitis in HIV-positive patients in the HAART era. PloS One 3: E1950.
12.
Chou,, L. S.,, R. E. Lewis,, C. Ippoliti,, R. E. Champlin, and, D. P. Kontoyiannis. 2007. Caspofungin as primary antifungal prophylaxis in stem cell transplant recipients. Pharmacotherapy 27: 1644– 1650.
13.
de Castro,, L. E.,, O. A. Sarraf,, J. M. Lally,, H. P. Sandoval,, K. D. Solomon, and, D. T. Vroman. 2005. Cryptococcus albidus keratitis after corneal transplantation. Cornea 24: 882– 883.
14.
D’Elios,, M. M.,, R. Josien,, M. Manghetti,, A. Amedei,, M. de Carli,, M. C. Cuturi,, G. Blancho,, F. Buzelin,, G. del Prete, and, J. P. Soulillou. 1997. Predominant Th1 cell infiltration in acute rejection episodes of human kidney grafts. Kidney Int. 51: 1876– 1884.
15.
Diamond, R. D., and, J. E. Bennett. 1974. Prognostic factors in cryptococcal meningitis: a study in 111 cases. Ann. Intern. Med. 80: 176– 181.
16.
Dilhuydy, M. S.,, T. Jouary,, H. Demeaux, and, A. Ravaud. 2007. Cutaneous cryptococcosis with alemtuzumab in a patient treated for chronic lymphocytic leukaemia. Br. J. Haematol. 137: 490.
17.
Drew,, R. H.,, and J. R. Perfect. 2004. Flucytosine. In D. Raoult,, R. Weber, and, V. L. Yu (ed.), Antimicrobial Therapy and Vaccines. Apple Trees Productions, New York, NY.
18.
Dromer,, F., S. Mathoulin-Pélissier,, A. Fontanet,, O. Ronin,, B. Dupont,, O. Lortholary, and French Cryptococcosis Study Group. 2004. Epidemiology of HIV-associated cryptococcosis in France (1985–2001): comparison of the pre- and post-HAART eras. AIDS 18: 255– 262.
19.
Dromer, F.,, S. Mathoulin-Pélissier,, O. Launay,, O. Lortholary, and French Cryptococcosis Study Group. 2007. Determinants of disease presentation and outcome during cryptococcosis: the CryptoA/D study. PloS Med. 4: E21.
20.
Dromer, F.,, S. Mathoulin,, B. Dupont,, L. Letenneur, and, O. Ronin. 1996. Individual and environmental factors associated with infection due to Cryptococcus neoformans serotype D. Clin. Infect. Dis. 23: 91– 96.
21.
Ferraris,, J. R.,, M. L. Tambutti,, R. L. Cardoni, and N. Prigoshin. 2004. Conversion from cyclosporine A to tacrolimus in pediatric kidney transplant recipients with chronic rejection: changes in the immune responses. Transplantation 77: 532– 537.
22.
Garcia-Hermoso, D.,, G. Janbon, and, F. Dromer. 1999. Epidemiological evidence for dormant Cryptococcus neoformans infection. J. Clin. Microbiol. 37: 3204– 3209.
23.
Gloster, H. M., Jr.,, R. A. Swerlick, and, A. R. Solomon. 1994. Cryptococcal cellulitis in a diabetic kidney transplant patient. J. Am. Acad. Dermatol. 30: 1025– 1026.
24.
Gorlach,, J.,, D. S. Fox,, N. S. Cutler,, G. M. Cox,, J. R. Perfect, and J. Heitman. 2000. Identification and characterization of a highly conserved calcineurin binding protein, CBP1/calcipressin, in Cryptococcus neoformans. EMBO J. 19: 1– 12.
25.
Gras, J.,, A. Cornet,, D. Latinne, and, R. Reding. 2004. Evidence that Th1/Th2 immune deviation impacts on early graft acceptance after pediatric liver transplantation: results of immunological monitoring in 40 children. Am. J. Transplant 4: 444.
26.
Hall,, J. C.,, J. H. Brewer,, T. T. Crouch, and, K. R. Watson. 1987. Cryptoccal cellulitis with multiple sites of involvement. J. Am. Acad. Dermatol. 17: 329– 332.
27.
[Reference deleted.]
28.
Haugen, R. K., and, R. D. Baker. 1954. The pulmonary lesions in cryptococcosis with special reference to subpleural nodules. Am. J. Clin. Pathol. 37: 1381– 1390.
29.
Hellman,, R. N.,, J. Hinrichs,, G. Sicard,, R. Hoover,, P. Golden, and P. Hoffsten. 1981. Cryptococcal pyelonephritis and disseminated cryptococcosis in a renal transplant recipient. Arch. Intern. Med. 141: 128– 130.
30.
Hodge, S.,, G. Hodge,, R. Flower, and, P. Han. 1999. Methylprednisolone upregulates monocyte IL-10 production in stimulated whole blood. Scand. J. Immunol. 49: 548– 553.
31.
Horrevorts,, A. M.,, F. T. M. Huysmans,, R. J. J. Koopman,, F. Jacques, and, G. M. Meis. 1994. Cellulitis as first clinical presentation of disseminated cryptococcosis in renal transplant recipients. Scand. J. Infect. Dis. 26: 623– 626.
32.
Husain, C.,, M. M. Wagener, and, N. Singh. 2001. Cryptococcus neoformans infection in organ transplant recipients: variables influencing clinical characteristics and outcome. Emerg. Infect. Dis. 7: 375– 381.
33.
Husain, S.,, M. M. Wagener, and, N. Singh. 2001. Cryptococcus neoformans in organ transplant recipients: correlates of variability in clinical characteristics and outcome. Emerg. Infect. Dis. 7: 375– 381.
34.
Ingram, P. R.,, R. Howman,, M. F. Leahy, and, J. R. Dyer. 2007. Cryptococcal immune reconstitution inflammatory syndrome following alemtuzumab therapy. Clin. Infect. Dis. 44: e115– e117.
35.
Jabbour, N.,, J. Reyes,, S. Kusne,, M. Martin, and, J. Fung. 1996. Cryptococcal meningitis after liver transplantation. Transplantation 61: 146– 167.
36.
Jarvis, J. N., and, T. S. Harrison. 2008. Pulmonary cryptococcosis. Semin. Respir. Crit. Care Med. 29: 141– 150.
37.
Kanj,, S. S.,, K. Welty-Wolf,, J. Madden,, V. Tapson,, M. A. Baz,, D. Davis, and, J. R. Perfect. 1996. Fungal infections in lung and heartlung transplant recipients: report of 9 cases and review of the literature. Medicine 75: 142– 156.
38.
Kapoor,, A.,, S. M. Flenchner,, K. O’Malley,, D. Paolone,, T. M. File, Jr., and, A. F. Cutrona. 1999. Cryptococcal meningitis in renal transplant patients associated with environmental exposure. Transplant. Infect. Dis. 1: 213– 217.
39.
Kontoyiannis,, D. P.,, R. E. Lewis,, B. D. Alexander,, O. Lortholary,, F. Dromer,, K. L. Gupta,, G. T. John,, R. Del Busto,, G. B. Klintmalm,, J. Somani,, G. M. Lyon,, K. Pursell,, V. Stosor,, P. Munoz,, A. P. Limaye,, A. C. Kalil,, T. L. Pruett,, J. Garcia-Diaz,, A. Humar,, S. Houston,, A. A. House,, D. Wray,, S. Orloff,, L. A. Dowdy,, R. A. Fisher,, J. Heitman,, N. D. Albert,, M. M. Wagener, and N. Singh. 2008. Calcineurin inhibitor agents interact synergistically with antifungal agents in vitro against Cryptococcus neoformans isolates: correlation with outcome in solid organ transplant recipients with cryptococcosis. Antimicrob. Agents Chemother. 52: 735– 738.
40.
Kontoyiannis,, D. P.,, K. Marr,, B. J. Park,, B. D. Alexander,, E. J. Anaissie,, T. J. Walsh,, J. Ito,, D. R. Andes,, J. W. Baddley,, J. M. Brown,, L. M. Brumble,, A. G. Freifeld,, S. Hadley,, L. A. Herwaldt,, C. A. Kauffman,, K. Knapp,, G. M. Lyon,, V. A. Morrison,, G. Papanicolaou,, T. F. Patterson,, T. M. Perl,, M. G. Schuster,, R. Walker,, K. A. Wannemuehler,, J. R. Wingard,, T. M. Chiller, and, P. G. Pappas. 2007. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001–2006; overview of the TRANSNET database. Clin. Infect. Dis. 50: 1091– 1100.
41.
Krcmery, V., Jr.,, A. Kunova, and, J. Mardiak. 1997. Nosocomial Cryptococcus laurentii fungemia in a bone marrow transplant patient after prophylaxis with ketoconazole successfully treated with oral fluconazole. Infection 25: 130.
42.
Lanternier,, F.,, M. O. Chandesris,, S. Poirée,, M. E. Bougnoux,, F. Mechai,, M. F. Mamzer-Bruneed,, J. P. Viard,, L. L. M. Galmiche-Rolland, and, O. Lortholary. 2007. Cellulitis revealing a cryptococcosis-related immune reconstitution inflammatory syndrome in a renal allograft recipient. Am. J. Transplant. 12: 2826– 2828.
43.
Lortholary, O.,, K. Sitbon,, F. Dromer, and the French Cryptococcosis Study Group. 2005. Evidence for HIV and Cryptococcus neoformans interactions in the proinflammatory and anti-inflammatory responses in blood during AIDS-associated cryptococcosis. Clin. Microbiol. Infect. 11: 296– 300.
44.
MacDougall,, L.,, S. E. Kidd,, E. Galanis,, S. Mak,, M. J. Leslie,, P. R. Cieslak,, J. W. Kronstad,, M. G. Morshed, and, K. H. Bartlett. 2007. Spread of Cryptococcus gattii in British Columbia, Canada, and detection in the Pacific Northwest, USA. Emerg. Infect. Dis. 13: 42– 50.
45.
McManus, E. J., and, J. M. Jones. 1985. Detection of a Trichosporon beigelii antigen cross-reactive with Cryptococcus neoformans capsular polysaccharide in serum from a patient with disseminated Trichosporon infection. J. Clin. Microbiol. 21: 681– 685.
46.
Mendpara,, S. D.,, C. Ustun,, A. M. Kallab,, F. M. Mazzella,, P. A. Bilodeau, and, A. P. Jillella. 2002. Cryptococcal meningitis following autologous stem cell transplantation in a patient with multiple myeloma. Bone Marrow Transplant 30: 259– 260.
47.
Mueller, N. J., and, J. A. Fishman. 2003. Asymptomatic pulmonary cryptococcosis in solid organ transplantation: report of four cases and review of the literature. Transplant Infect. Dis. 5: 140– 143.
48.
Neuville,, S.,, F. Dromer,, O. Morin,, B. Dupont,, O. Ronin, and O. Lortholary. 2003. Primary cutaneous cryptococcosis: a distinct clinical entity. Clin. Infect. Dis. 36: 337– 347.
49.
Nosanchuk,, J. D.,, S. Shoham,, B. C. Fries,, D. S. Shapiro,, S. M. Levitz, and A. Casadevall. 2000. Evidence of zoonotic transmission of Cryptococcus neoformans from a pet cockatoo to an immunocompromised patient. Ann. Intern. Med. 132: 205– 208.
50.
Ooi,, H. S.,, B. T. M. Chen,, H. L. Cheng,, O. T. Khoo, and, K. T. Chan. 1971. Survival of a patient transplanted with a kidney infected with Cryptococcus neoformans. Transplantation 11: 428– 429.
51.
Pappas,, P. G.,, J. R. Perfect,, G. A. Cloud,, R. A. Larsen,, G. A. Pankey,, D. J. Lancaster,, H. Henderson,, C. A. Kauffman,, D. W. Haas,, M. Saccente,, R. J. Hamill,, S. Holloway,, R. M. Warren, and, W. E. Dismukes. 2001. Cryptococcosis in human immunodeficiency virus-negative patients in the era of effective azole therapy. Clin. Infect. Dis. 33: 690– 699.
52.
Paya, C. V. 1993. Fungal infections in solid-organ transplantation. Clin. Infect. Dis. 16: 677– 688.
53.
Peleg,, A. Y.,, S. Husain,, E. J. Kwak,, F. P. Silveira,, M. Ndirangu,, J. Tran,, K. A. Shutt,, R. Shapiro,, N. Thai,, K. Abu-Elmagd,, K. R. McCurry,, A. Marcos, and, D. L. Paterson. 2007. Opportunistic infections in 547 organ transplant recipients receiving alemtuzumab, a humanized monoclonal DC-52 antibody. Clin. Infect. Dis. 44: 204– 212.
54.
Perfect,, J. R.,, W. E. Dismukes,, F. Dromer,, D. L. Goldman,, J. R. Graybill,, R. J. Hamill,, T. S. Harrison,, R. A. Larsen,, O. Lortholary,, M. H. Nguyen,, P. G. Pappas,, W. G. Powderly,, N. Singh,, J. D. Sobel, and, T. C. Sorrell. 2010. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin. Infect. Dis. 50: 291– 322.
55.
Perry, H. D., and, E. D. Donnenfeld. 1990. Cryptococcal keratitis after keratoplasty. Am. J. Ophthalmol. 110: 320– 321.
56.
Perry,, H. D.,, S. J. Doshi,, E. D. Donnenfeld, and, G. S. Bai. 2002. Topical cyclosporin A in the management of therapeutic keratoplasty for mycotic keratitis. Cornea 21: 161– 163.
57.
Ramchandren, R., and, D. E. Gladstone. 2004. Cryptococcus albidus infection in a patient undergoing autologous progenitor cell transplant. Transplantation 77: 956.
58.
Rimek, D.,, G. Haase,, A. Luck,, J. Casper, and, A. Podbielski. 2004. First report of a case of meningitis caused by Cryptococcus adeliensis in a patient with acute myeloid leukemia. J. Clin. Microbiol. 42: 481– 483.
59.
Ritterband,, D. C.,, J. A. Seedor,, M. K. Shah,, S. Waheed, and I. Schorr. 1998. A unique case of Cryptococcus laurentii keratitis spread by a rigid gas permeable contact lens in a patient with onychomycosis. Cornea 17: 115– 118.
60.
Saag, M. S., R. J. Graybill,, R. A. Larsen,, P. G. Pappas,, J. R. Perfect,, W. G. Powderly,, J. D. Sobel,, W. E. Dismukes, for the Mycoses Study Group Cryptococcal Subproject. 2000. Practice guidelines for the management of cryptococcal disease. Clin. Infect. Dis. 30: 710– 718.
61.
Safdar, N.,, C. L. Abad,, S. Narayan,, D. R. Kaul, and, S. Saint. 2009. Clinical problem-solving. Keeping an open mind. N. Engl. J. Med. 360: 72– 76.
62.
Saha,, D. C.,, D. L. Goldman,, X. Shao,, A. Casadevall,, S. Husain,, A. P. Limaye,, M. Lyon,, J. Somani,, K. Pursell,, T. L. Pruett, and N. Singh. 2007. Serologic evidence for reactivation of cryptococcosis in solid-organ transplant recipients. Clin. Vaccine Immunol. 14: 1550– 1554.
63.
Shea,, Y. R. 2007. Algorithms for detection and identification of fungi, p. 1745–1761. In P. R. Murray,, E. J. Baron,, J. H. Jorgensen,, M. L. Landry, and, M. A. Pfaller (ed.), Manual of Clinical Microbiology, 9th ed. ASM Press, Washington, DC.
64.
Silveira,, E. P.,, S. Husain,, E. J. Kwak,, P. K. Linden,, A. Marcos,, R. Shapiro,, P. Fontes,, J. W. Marsh,, M. de Vera,, K. Tom,, N. Thai,, H. P. Tan,, A. Basu,, K. Soltys, and, D. L. Paterson. 2007. Cryptococcosis in liver and kidney transplant recipients receiving antithymocyte globulin or alemtuzumab. Transplant Infect. Dis. 9: 22– 27.
65.
Singh,, N.,, B. D. Alexander,, O. Lortholary,, F. Dromer,, K. L. Gupta,, G. T. John,, R. del Busto,, G. B. Klintmalm,, J. Somani,, G. M. Lyon,, K. Pursell,, V. Stosor,, P. Munoz,, A. P. Limaye,, A. C. Kalil,, T. L. Pruett,, J. Garcia-Diaz,, A. Humar,, S. Houston,, A. A. House,, D. Wray,, S. Orloff,, L. A. Dowdy,, R. A. Fisher,, J. Heitman,, M. M. Wagener, and S. Husain. 2008. Pulmonary cryptococcosis in solid organ transplant recipients: clinical relevance of serum cryptococcal antigen. Clin. Infect. Dis. 46: e12– e18.
66.
Singh,, N.,, B. D. Alexander,, O. Lortholary,, F. Dromer,, K. L. Gupta,, G. T. John,, R. del Busto,, G. B. Klintmalm,, J. Somani,, G. M. Lyon,, K. Pursell,, V. Stosor,, P. Munoz,, A. P. Limaye,, A. C. Kalil,, T. L. Pruett,, J. Garcia-Diaz,, A. Humar,, S. Houston,, A. A. House,, D. Wray,, S. Orloff,, L. A. Dowdy,, R. A. Fisher,, J. Heitman,, M. M. Wagener,, S. Husain, and the Cryptococcal Collaborative Transplant Study Group. 2007. Cryptococcus neoformans in organ transplant recipients: impact of calcineurin-inhibitor agents on mortality. J. Infect. Dis. 195: 756– 764.
67.
Singh, N.,, F. Dromer,, J. R. Perfect, and, O. Lortholary. 2008. Cryptococcosis in solid organ transplant recipients: current state of the science. Clin. Infect. Dis. 47: 1321– 1327.
68.
Singh,, N.,, G. Forrest,, C. Sifri,, B. Alexander,, L. Johnson,, M. Lyon,, O. Lortholary, and Cryptococcal Collaborative Transplant Study Group. 2008. Cryptococcus-associated immune reconstitution syndrome (IRS) in solid organ transplant (SOT) recipients: results from a prospective, multicenter study, abstract #2152, 48th Annual ICAAC/IDSA 46th Annual Meeting Washington, DC 25 to 28 October.
69.
Singh,, N.,, O. Lortholary,, B. D. Alexander,, K. L. Gupta,, G. T. John,, K. Pursell,, P. Munoz,, G. B. Klintmalm,, V. Stosor,, R. Del Busto,, A. P. Limaye,, J. Somani,, M. Lyon,, S. Houston,, A. A. House,, T. L. Pruett,, S. Orloff,, A. Humar,, L. Dowdy,, J. Garcia-Diaz,, R. A. Fisher,, S. Husain, and the Cryptococcal Collaborative Transplant Study Group. 2005. Allograft loss in renal transplant recipients with C. neoformans associated immune reconstitution syndrome. Transplantation 80: 1131– 1133.
70.
Singh,, N.,, O. Lortholary,, B. D. Alexander,, K. L. Gupta,, G. T. John,, K. Pursell,, P. Munoz,, G. B. Klintmalm,, V. Stosor,, R. Del Busto,, A. P. Limaye,, J. Somani,, M. Lyon,, S. Houston,, A. A. House,, T. L. Pruett,, S. Orloff,, A. Humar,, L. Dowdy,, J. Garcia-Diaz,, A. C. Kalil,, R. A. Fisher,, S. Husain, and the Cryptococcal Collaborative Transplant Study Group. 2005. An “immune reconstitution syndrome”-like entity associated with Cryptococcus neoformans infections in organ transplant recipients. Clin. Infect. Dis. 40: 1756– 1761.
71.
Singh,, N.,, O. Lortholary,, F. Dromer,, B. D. Alexander,, K. L. Gupta,, G. T. John,, R. del Busto,, G. B. Klintmalm,, J. Somani,, G. M. Lyon,, K. Pursell,, V. Stosor,, P. Munoz,, A. P. Limaye,, A. C. Kalil,, T. L. Pruett,, J. Garcia-Diaz,, A. Humar,, S. Houston,, A. A. House,, D. Wray,, S. Orloff,, L. A. Dowdy,, R. A. Fisher,, J. Heitman,, M. M. Wagener, and S. Husain. 2008. Central nervous system cryptococcosis in solid organ transplant recipients: clinical relevance of abnormal neuroimaging findings. Transplantation 86: 647– 651.
72.
Singh, N., and, D. L. Paterson. 2005. Aspergillus infections in transplant recipients. Clin. Microbiol. Rev. 18: 44– 69.
73.
Sun,, H. Y.,, M. M. Wagener,, and N. Singh. 2009. Cryptococcosis in solid-organ, hematopoietic stem cell, and tissue transplant recipients: evidence-based evolving trends. Clin. Infect. Dis. 48: 1566– 1576.
74.
Tanner,, D. C.,, M. P. Weinstein,, B. Fedorciw,, K. L. Joho,, J. J. Thorpe, and L. Reller. 1994. Comparison of commercial kits for detection of cryptococcal antigen. J. Clin. Microbiol. 32: 1680– 1684.
75.
Uslu,, A.,, A. Nart,, I. Coker,, S. Kose,, A. Aykas,, M. C. Kahya,, M. F. Yuzbasioglu, and M. Dogan. 2004. Two-day induction with thymoglobulin in kidney transplantation: risks and benefits. Transplant Proc. 36: 76– 79.
76.
Vilchez, R. A.,, J. Fung, and, S. Kusne. 2002. Cryptococcosis in organ transplant recipients: an overview. Am. J. Transplantation 2: 575– 580.
77.
Vilchez,, R. A.,, W. Irish,, J. Lacomis,, P. Costello,, J. Fung, and S. Kusne. 2001. The clinical epidemiology of pulmonary cryptococcosis in non-AIDS patients at a tertiary care medical center. Medicine 80: 308– 312.
78.
Winston, D. J., C. Emmanouilides, and, R. W. Busuttil. 1995. Infections in liver transplant recipients. Clin. Infect. Dis. 21: 1077– 1091.
79.
Wu,, G.,, R. A. Vilchez,, B. Eidelman,, J. Fung,, R. Kormos, and S. Kusne. 2002. Cryptococcal meningitis: an analysis among 5521 consecutive organ transplant recipients. Transplant Infect. Dis. 4: 183– 188.
Tables
Cryptococcosis in Transplant Recipients
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Citation:
Singh N, Alexander B.
2011.
Cryptococcosis in Transplant Recipients,
p 507-514.
In
Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed),
Cryptococcus.
ASM Press, Washington, DC.
doi: 10.1128/9781555816858.ch37
/content/10.1128/9781555816858.ch37.ch37table01
TABLE 1
Clinical and laboratory characteristics of SOT recipients with CNS cryptococcosis
a
TABLE 1
Clinical and laboratory characteristics of SOT recipients with CNS cryptococcosis a
Citation:
Singh N, Alexander B.
2011.
Cryptococcosis in Transplant Recipients,
p 507-514.
In
Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed),
Cryptococcus.
ASM Press, Washington, DC.
doi: 10.1128/9781555816858.ch37
/content/10.1128/9781555816858.ch37.ch37table02
TABLE 2
Management of cryptococcal disease in SOT recipients
TABLE 2
Management of cryptococcal disease in SOT recipients
Citation:
Singh N, Alexander B.
2011.
Cryptococcosis in Transplant Recipients,
p 507-514.
In
Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed),
Cryptococcus.
ASM Press, Washington, DC.
doi: 10.1128/9781555816858.ch37