Successful treatment of disseminated cryptococcosis in a liver transplant recipient with fluconazole and flucytosine, an all oral regimen

Singh, Nina; Gayowski, Timothy; Marino, Ignazio R.

doi:10.1111/j.1432-2277.1998.tb00958.x

Cited by 33 publications

(13 citation statements)

References 10 publications

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“…An all-oral regimen of fluconazole plus flucytosine for nonmeningeal cryptococcosis has been used [61].…”

Section: Cryptococcal Infectionsmentioning

confidence: 99%

Fungal infections in solid organ transplantation

Marik¹

2006

Expert Opinion on Pharmacotherapy

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Renal, liver, heart and lung transplantation are now considered to be the standard therapeutic interventions in patients with end-stage organ failure. Infectious complications following transplantation are relatively common due to the transplant recipients overall immunosuppressed status. The incidence of invasive mycoses following solid organ transplant ranges from 5 to 42% depending on the organ transplanted. These mycoses are associated with high overall mortality rates. Candida and Aspergillus spp. produce most of these infections. This article will review the risk factors, clinical presentation and treatment of invasive fungal infections in solid organ transplant patients, and evaluate the role of prophylactic therapy in this group of patients.

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“…An all-oral regimen of fluconazole plus flucytosine for nonmeningeal cryptococcosis has been used [61].…”

Section: Cryptococcal Infectionsmentioning

confidence: 99%

Fungal infections in solid organ transplantation

Marik¹

2006

Expert Opinion on Pharmacotherapy

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“…Toxinproducing strains of these organisms (which are associated with aggressive skin disease or severe multisystem failure) have been described in liver transplant recipients [2]. Occasional episodes mimicking gram-positive cellulitis but due to Cryptococcus neoformans have been described [3,4].…”

Section: Introductionmentioning

confidence: 98%

Spontaneous Gram-Negative Cellulitis in a Liver Transplant Recipient

Paterson¹,

Gruttadauria

Lauro

et al. 2001

Infection

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A 47-year-old liver transplant recipient developed fever and cellulitis on the 8th post-transplant day. The clinical appearances were of a rapidly advancing cellulitis. The patient had a past history of severe peripheral edema and hypoalbuminemia. Blood cultures and skin biopsy grew Escherichia coli. To our knowledge, this is the first reported case of E. coli cellulitis in a liver transplant recipient. However, cases have previously been described in patients with cirrhosis or idiopathic nephritic syndrome, conditions which share predisposing features of peripheral edema and hypoalbuminemia. Bacteremic gram-negative cellulitis should be considered in compromised patients with unusual presentations of cellulitis.

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“…Predisposing factors for cryptococcal osteomyelitis include solid organ transplant, immunosuppressant medication use, diabetes mellitus and HIV 11. We present here an interesting case of cryptococcemia in a solid organ transplant recipient manifesting as osteomyelitis and an intramuscular abscess 12. This rare presentation highlights the importance of considering cryptococcal infection in immunocompromised patients with osseous lesions.…”

Section: Introductionmentioning

confidence: 82%

Cryptococcus neoformansosteomyelitis and intramuscular abscess in a liver transplant patient

2017

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is an important pathogen that can cause severe illness and mortality in immunocompromised patients. We highlight here the case of a 53-year-old man presenting to hospital 4 years postliver transplant with fever, acute renal failure and a medial thigh lesion. Initially treated as bacterial sepsis, the patient failed to improve on broad-spectrum antibiotics. Further investigations revealed disseminated cryptococcemia complicated by patellar osteomyelitis and an intramuscular abscess. Unfortunately, although the patient initially showed signs of clinical improvement after starting standard antifungal agents, he deteriorated and died secondary to acute renal failure. Osteomyelitis is a rare manifestation of cryptococcal infection for which there is often a significant delay to diagnosis and treatment. This is the fourth reported case of cryptococcal osteomyelitis in a liver transplant patient and underlines the importance of considering fungal infections in the differential diagnosis of osseous lesions in solid organ transplant and other immunocompromised patients.

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Successful treatment of disseminated cryptococcosis in a liver transplant recipient with fluconazole and flucytosine, an all oral regimen

Cited by 33 publications

References 10 publications

Fungal infections in solid organ transplantation

Fungal infections in solid organ transplantation

Spontaneous Gram-Negative Cellulitis in a Liver Transplant Recipient

Cryptococcus neoformansosteomyelitis and intramuscular abscess in a liver transplant patient

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