Pulmonary cryptococcosis in solid organ transplant recipients: Clinical relevance of serum cryptococcal antigen

Singh, Nina, Alexander, Barbara D., Lortholary, Olivier, Dromer, Françoise, Gupta, Krishan L., John, George T., del Busto, Ramon, Klintmalm, Goran B., Somani, Jyoti, Lyon, G. Marshall, Pursell, Kenneth, Stosor, Valentina, Munoz, Patricia, Limaye, Ajit P., Kalil, Andre C., Pruett, Timothy L., Garcia-Diaz, Julia, Humar, Atul, Houston, Sally, House, Andrew A., Wray, Dannah, Orloff, Susan, Dowdy, Lorraine A., Fisher, Robert A., Heitman, Joseph, Wagener, Marilyn M. and Husain, Shahid (2008) Pulmonary cryptococcosis in solid organ transplant recipients: Clinical relevance of serum cryptococcal antigen. Clinical Infectious Diseases, 46 2: E12-E18. doi:10.1086/524738


Author Singh, Nina
Alexander, Barbara D.
Lortholary, Olivier
Dromer, Françoise
Gupta, Krishan L.
John, George T.
del Busto, Ramon
Klintmalm, Goran B.
Somani, Jyoti
Lyon, G. Marshall
Pursell, Kenneth
Stosor, Valentina
Munoz, Patricia
Limaye, Ajit P.
Kalil, Andre C.
Pruett, Timothy L.
Garcia-Diaz, Julia
Humar, Atul
Houston, Sally
House, Andrew A.
Wray, Dannah
Orloff, Susan
Dowdy, Lorraine A.
Fisher, Robert A.
Heitman, Joseph
Wagener, Marilyn M.
Husain, Shahid
Title Pulmonary cryptococcosis in solid organ transplant recipients: Clinical relevance of serum cryptococcal antigen
Journal name Clinical Infectious Diseases   Check publisher's open access policy
ISSN 1058-4838
Publication date 2008-01
Sub-type Article (original research)
DOI 10.1086/524738
Volume 46
Issue 2
Start page E12
End page E18
Total pages 7
Place of publication United States
Publisher Oxford University Press
Language eng
Formatted abstract
Background.
The role of serum cryptococcal antigen in the diagnosis and determinants of antigen positivity in solid organ transplant (SOT) recipients with pulmonary cryptococcosis has not been fully defined.

Methods.
We conducted a prospective, multicenter study of SOT recipients with pulmonary cryptococcosis during 1999-2006.

Results.

Forty (83%) of 48 patients with pulmonary cryptococcosis tested positive for cryptococcal antigen. Patients with concomitant extrapulmonary disease were more likely to have a positive antigen test result (P = .018), and antigen titers were higher in patients with extrapulmonary disease (P = .003) or fungemia (P = .045). Patients with single nodules were less likely to have a positive antigen test result than were those with all other radiographic presentations (P = .053). Among patients with isolated pulmonary cryptococcosis, lung transplant recipients were less likely to have positive cryptococcal antigen test results than were recipients of other types of SOT (Pp.003). In all, 38% of the patients were asymptomatic or had pulmonary cryptococcosis detected as an incidental finding. Nodular densities or mass lesions were more likely to present as asymptomatic or incidentally detected pulmonary cryptococcosis than as pleural effusions and infiltrates (P = .008).

Conclusions.
A positive serum cryptococcal antigen test result in SOT recipients with pulmonary cryptococcosis appears to reflect extrapulmonary or more advanced radiographic disease.
Keyword Neoformans Infection
Cerebrospinal-Fluid
Fungal-Infections
Aids
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collections: ERA 2012 Admin Only
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