Cutaneous Cryptococcal Infection in Renal Transplant Recipient

Year 2019, Volume: 09 Issue: 04, 164 - 166, 15.12.2019

Jhansi Vani Devana Saleem Mohammed Abdul Vikrantha Reddy

https://doi.org/10.5799/jmid.657899

Abstract

Invasive fungal infections occur in 5-59% of solid organ transplant recipients. Among fungal infections, Cryptococcus remains a significant opportunistic infection in solid organ transplant recipients. The incidence of cryptococcal infection in solid organ recipients was about 2.8 per 100 transplant recipients. Mortality rates in organ transplant recipients with cryptococcosis range from 15% to 20%.The type of primary immunosuppressive agents used in solid organ transplant recipients influences the predominant clinical manifestations of cryptococcosis. Patients who are receiving tacrolimus were significantly less likely to have central nervous system involvement and more likely to have skin, soft tissue and osteoarticular involvement than patients receiving non tacrolimus-based immunosuppressive agents We report a case of cutaneous Cryptococcus neoformans infection in 59 years old renal transplant recipient who underwent renal transplantation ten years ago. He was on immunosuppressant drugs like tacrolimus. High clinical suspicion will help in early diagnosis and treatment. J Microbiol Infect Dis 2019; 9(4):164-166.

Keywords

Renal transplant recipient, Cryptococcus neoformans, tacrolimus, Amphotericin B

References

• 1. Vilchez RA, Fung J, Kusne S. Cryptococcosis in organ transplant recipients: an overview. Am J Transplant 2002; 2:575-580 2. Decken K, Kohler G, Palmer-Lehmann K, et al. Interleukin-12 is essential for protective Th1 response in mice infected with Cryptococcus neoformsnans. Infect Immun 1998; 66:4994-5000. 3. Sun HY, Alexander BD, Huprikar S, et al. Predictors of Immune Reconstitution Syndrome in organ transplant recipients with Cryptococcosis: Implications for the management of Immunosuppression. Clin Inf Dis 2015; 60(1):36-44. 4. .Singh N, Forrest G. AST Infectious Diseases Community of Practice. Crtptococcosis in solid organ transplant recipients. Am J Transplant 2009; 9 (suppl 4) S192-S198. 5. Pappas PG, Alexander BD, Andes DR, et al. Invasive fungal infections among organ transplant recipients: Results of the Transplant-associated infection surveillance Network (TRANANET) Clin Infect Dis 2010; 50:1101-1011. 6. Agarwal C, Sood V, Kumar A, et al. Cryptococcal infection in transplant kidney manifesting as chronic allograft dysfunction. Indian J Nephrol 2017; 27(5):392-394.