Cutaneous cryptococcosis in solid organ transplant recipients

Sun, Hsin-Yun, Alexander, Barbara D., Lortholary, Olivier, Dromer, Francoise, Forrest, Graeme N., Lyon, G. Marshall, Somani, Jyoti, Gupta, Krishan L., Del Busto, Ramon, Pruett, Timothy L., Sifri, Costi D., Limaye, Ajit P., John, George T., Klintmalm, Goran B., Pursell, Kenneth, Stosor, Valentina, Morris, Michele I., Dowdy, Lorraine A., Munoz, Patricia, Kalil, Andre C., Garcia-Diaz, Julia, Orloff, Susan L., House, Andrew A., Houston, Sally H., Wray, Dannah, Huprikar, Shirish, Johnson, Leonard B., Humar, Atul, Razonable, Raymund R., Fisher, Robert A., Husain, Shahid, Wagener, Marilyn M., Singh, Nina and The Crytococcal Collaborative Transplant Study Group (2010) Cutaneous cryptococcosis in solid organ transplant recipients. Medical Mycology, 48 6: 785-791. doi:10.3109/13693780903496617

Author Sun, Hsin-Yun
Alexander, Barbara D.
Lortholary, Olivier
Dromer, Francoise
Forrest, Graeme N.
Lyon, G. Marshall
Somani, Jyoti
Gupta, Krishan L.
Del Busto, Ramon
Pruett, Timothy L.
Sifri, Costi D.
Limaye, Ajit P.
John, George T.
Klintmalm, Goran B.
Pursell, Kenneth
Stosor, Valentina
Morris, Michele I.
Dowdy, Lorraine A.
Munoz, Patricia
Kalil, Andre C.
Garcia-Diaz, Julia
Orloff, Susan L.
House, Andrew A.
Houston, Sally H.
Wray, Dannah
Huprikar, Shirish
Johnson, Leonard B.
Humar, Atul
Razonable, Raymund R.
Fisher, Robert A.
Husain, Shahid
Wagener, Marilyn M.
Singh, Nina
The Crytococcal Collaborative Transplant Study Group
Title Cutaneous cryptococcosis in solid organ transplant recipients
Journal name Medical Mycology   Check publisher's open access policy
ISSN 1369-3786
Publication date 2010-09
Sub-type Article (original research)
DOI 10.3109/13693780903496617
Volume 48
Issue 6
Start page 785
End page 791
Total pages 7
Place of publication London, U.K.
Publisher Informa Healthcare
Collection year 2011
Language eng
Formatted abstract
Clinical manifestations, treatment, and outcomes of cutaneous cryptococcosis in solid organ transplant (SOT) recipients are not fully defined. In a prospective cohort comprising 146 SOT recipients with cryptococcosis, we describe the presentation, antifungal therapy, and outcome of cutaneous cryptococcal disease. Cutaneous cryptococcosis was documented in 26/146 (17.8%) of the patients and manifested as nodular/mass (34.8%), maculopapule (30.4%), ulcer/pustule/abscess (30.4%), and cellulitis (30.4%) with 65.2% of the skin lesions occurred in the lower extremities. Localized disease developed in 30.8% (8/26), and disseminated disease in 69.2% (18/26) with involvement of the central nervous system (88.9%, 16/18), lung (33.3%, 6/18), or fungemia (55.6%, 10/18). Fluconazole (37.5%) was employed most often for localized and lipid formulations of amphotericin B (61.1%) for disseminated disease. Overall mortality at 90 days was 15.4% (4/26) with 16.7% in disseminated and 12.5% in localized disease (P 0.78). SOT recipients who died were more likely to have renal failure (75.0% vs. 13.6%, P 0.028), longer time to onset of disease after transplantation (87.5 vs. 22.6 months, P 0.023), and abnormal mental status (75% vs. 13.6%, P 0.028) than those who survived. Cutaneous cryptococcosis represents disseminated disease in most SOT recipients and preferentially involves the extremities. Outcomes with appropriate management were comparable between SOT recipients with localized and disseminated cryptococcosis.
© 2010 ISHAM.
Keyword Cryptococcus
Fungal infections
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Medicine Publications
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Created: Mon, 28 Mar 2011, 12:36:08 EST by Debbie Banks on behalf of School of Medicine