Cryptococcal meningitis after liver transplantation.
(1996) Transplantation — Vol. 61, n° 1, p. 146-149 (1996)
Files
No attached file found for this publication.
Details
- Authors
- Abstract
- We present our experience with 10 liver transplant recipients in whom cryptococcal meningitis developed after liver transplantation. Disease developed a median period of 3.5 months (range, 2-36 months) after transplantation and patients were diagnosed a median period of 9 days (range, 2-90 days) after initial symptoms. Headache, fever, and mental status changes were the most frequent clinical presentations, while meningismus was found in only 30% of patients. Cerebrospinal fluid analysis was diagnostic in all cases. All patients were treated with amphotericin B and flucytosine. Immunosuppression was either decreased or discontinued during therapy. Five patients died, four as a direct result of cryptococcal infection and one as a result of chronic rejection. Three patients had long-term survival without any sequelae. One long-term survivor suffered blindness consequent to the disease. We conclude that cryptococcal meningitis is a rare complication in liver transplant recipients (0.25%), and has a high mortality rate (50%). Early recognition, combination antifungal therapy, and decrease or discontinuation of immunosuppression are important for cure. No relapse has been seen in surviving patients.
- Affiliations
University of Pittsburgh, School of Medicine, Pennsylvania, USA Pittsburgh Transplant Institute
Citations
Jabbour, N., Reyes, J., Kusne, S., Martin, M., & Fung, J. (1996). Cryptococcal meningitis after liver transplantation. Transplantation, 61(1), 146-149. https://hdl.handle.net/2078.5/189852 (Original work published 1996)