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Hepatic involvement in a liver transplant recipient with disseminated cryptococcosis.
Transpl Infect Dis. 2009 Apr; 11(2):179-82.TI

Abstract

Cryptococcosis occurs primarily in immunocompromised patients such as organ transplant recipients. Central nervous system and pulmonary infections are documented most frequently; hepatic involvement is rarely reported. We report a case of early hepatic cryptococcosis in a 54-year-old male liver transplant recipient. Two weeks after orthotopic liver transplant, he was readmitted with fever, malaise, diarrhea, and progressive pulmonary infiltrates. On admission, liver-associated enzymes were decreased from those at discharge after transplantation. Blood and bronchoalveolar lavage cultures were positive for Cryptococcus neoformans. Despite treatment with amphotericin B and flucytosine, the patient developed both marked cholestasis and transaminase elevation. A liver biopsy performed 22 days after admission revealed numerous yeast-like organisms in hepatic sinusoids consistent with C. neoformans. Despite treatment, the patient died 55 days after admission and 66 days after transplantation. Our case illustrates hepatic involvement of cryptococcal infection within the first month following transplantation.

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Authors+Show Affiliations

Lu S
Department of Pathology, VA Medical Center, Louisville, Kentucky, USA.
Furth EE
No affiliation info available
Blumberg EA
No affiliation info available
Bing Z
No affiliation info available

MeSH

Amphotericin BAntifungal AgentsCryptococcosisFatal OutcomeFlucytosineHumansImmunosuppressive AgentsLiver DiseasesLiver TransplantationMaleMiddle AgedPostoperative Complications

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19210677

Citation

Lu, S, et al. "Hepatic Involvement in a Liver Transplant Recipient With Disseminated Cryptococcosis." Transplant Infectious Disease : an Official Journal of the Transplantation Society, vol. 11, no. 2, 2009, pp. 179-82.
Lu S, Furth EE, Blumberg EA, et al. Hepatic involvement in a liver transplant recipient with disseminated cryptococcosis. Transpl Infect Dis. 2009;11(2):179-82.
Lu, S., Furth, E. E., Blumberg, E. A., & Bing, Z. (2009). Hepatic involvement in a liver transplant recipient with disseminated cryptococcosis. Transplant Infectious Disease : an Official Journal of the Transplantation Society, 11(2), 179-82. https://doi.org/10.1111/j.1399-3062.2009.00365.x
Lu S, et al. Hepatic Involvement in a Liver Transplant Recipient With Disseminated Cryptococcosis. Transpl Infect Dis. 2009;11(2):179-82. PubMed PMID: 19210677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatic involvement in a liver transplant recipient with disseminated cryptococcosis. AU - Lu,S, AU - Furth,E E, AU - Blumberg,E A, AU - Bing,Z, Y1 - 2009/02/06/ PY - 2009/2/13/entrez PY - 2009/2/13/pubmed PY - 2009/7/25/medline SP - 179 EP - 82 JF - Transplant infectious disease : an official journal of the Transplantation Society JO - Transpl Infect Dis VL - 11 IS - 2 N2 - Cryptococcosis occurs primarily in immunocompromised patients such as organ transplant recipients. Central nervous system and pulmonary infections are documented most frequently; hepatic involvement is rarely reported. We report a case of early hepatic cryptococcosis in a 54-year-old male liver transplant recipient. Two weeks after orthotopic liver transplant, he was readmitted with fever, malaise, diarrhea, and progressive pulmonary infiltrates. On admission, liver-associated enzymes were decreased from those at discharge after transplantation. Blood and bronchoalveolar lavage cultures were positive for Cryptococcus neoformans. Despite treatment with amphotericin B and flucytosine, the patient developed both marked cholestasis and transaminase elevation. A liver biopsy performed 22 days after admission revealed numerous yeast-like organisms in hepatic sinusoids consistent with C. neoformans. Despite treatment, the patient died 55 days after admission and 66 days after transplantation. Our case illustrates hepatic involvement of cryptococcal infection within the first month following transplantation. SN - 1399-3062 UR - https://www.unboundmedicine.com/medline/citation/19210677/Hepatic_involvement_in_a_liver_transplant_recipient_with_disseminated_cryptococcosis_ L2 - https://doi.org/10.1111/j.1399-3062.2009.00365.x DB - PRIME DP - Unbound Medicine ER -