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 = ...Continue Reading
References
Nov 1, 1986·Journal of Clinical Microbiology·S K ShraderJ D Band
Jun 1, 2000·Transplantation·G F RahmanD J Cohen
Dec 20, 2000·Transplantation Proceedings·T AsanoM Hayakawa
Mar 27, 2001·Emerging Infectious Diseases·A I HussainW Heneine
Dec 4, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·S AsciogluUNKNOWN Mycoses Study Group of the National Institute of Allergy and Infectious Diseases
Mar 27, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Per LjungmanCarlos Paya
Jan 23, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ségolène NeuvilleUNKNOWN French Cryptococcosis Study Group
Dec 4, 2003·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Ozgür BaşaranMehmet Haberal
Jan 7, 2005·Journal of Clinical Microbiology·Jill R BlankenshipJoseph Heitman
May 24, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Nina SinghUNKNOWN Cryptococcal Collaborative Transplant Study Group
Jul 6, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·S A SummersS Shaunak
Nov 10, 2005·Transplantation·Nina SinghUNKNOWN Cryptococcal Collaborative Transplant Study Group
Nov 29, 2005·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Jean-Philippe RerolleYann Le Meur
Jan 31, 2007·The Journal of Infectious Diseases·Nina SinghUNKNOWN Cryptococcal Collaborative Transplant Study Group
May 25, 2007·The Lancet Infectious Diseases·Nina Singh, John R Perfect
Aug 19, 2007·Transplant Infectious Disease : an Official Journal of the Transplantation Society·S PlaceM Estenne
Oct 12, 2007·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·F LanternierO Lortholary
Dec 19, 2007·Transplant Infectious Disease : an Official Journal of the Transplantation Society·A EgliH H Hirsch
Jan 4, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Nina SinghShahid Husain
Jan 25, 2008·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·N Singh
Sep 16, 2008·Transplantation·Nina SinghUNKNOWN Cryptococcal Collaborative Transplant Study Group
Nov 1, 2008·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Gonzalo CrespoMiquel Navasa
Nov 13, 2008·Transplant Infectious Disease : an Official Journal of the Transplantation Society·J OrsiniG P Wormser
May 1, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Hsin-Yun SunNina Singh
Oct 1, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Hsin-Yun SunUNKNOWN Cryptococcal Collaborative Transplant Study Group
Citations
Jan 1, 2011·BMJ Case Reports·Tristan FerryJean Kanitakis
Sep 7, 2012·Case Reports in Otolaryngology·David R ReinstadlerEllie Maghami
May 10, 2012·Future Microbiology·Shmuel Shoham, Kieren A Marr
Jan 8, 2016·Infectious Disease Clinics of North America·Judith A Anesi, John W Baddley
Apr 16, 2013·Transplant Infectious Disease : an Official Journal of the Transplantation Society·D WootenL P Fox
Nov 11, 2011·The Australasian Journal of Dermatology·Haady FallahIan McCrossin
Mar 8, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J W BaddleyUNKNOWN AST Infectious Diseases Community of Practice
Aug 3, 2011·Transplant International : Official Journal of the European Society for Organ Transplantation·Claudio Ponticelli, Pier Luca Bencini
Jun 22, 2012·International Journal of Dermatology·Sílvio A MarquesMariangela E A Marques
Jun 28, 2011·The American Journal of Pathology·Daniel PiehlerUwe Müller
Oct 22, 2016·JAAD Case Reports·Hovik J AshchyanMisha Rosenbach
Sep 8, 2016·Medical Mycology·Nina SinghHsin Yun Sun
Jun 30, 2018·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Saira AjmalMark Wilhelm
Jan 31, 2019·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Gabriel Sebastián Díaz-RamírezJuan Carlos Restrepo-Gutiérrez
Mar 23, 2019·Clinical Transplantation·John W BaddleyUNKNOWN AST Infectious Diseases Community of Practice
Jun 21, 2014·The American Journal of Dermatopathology·Angel Fernandez-FloresRoberto Arenas-Guzman
Dec 4, 2019·Medical Mycology Journal·Hiromitsu NoguchiHironobu Ihn
Dec 6, 2018·Indian Journal of Dermatology, Venereology and Leprology·Rajsmita BhattacharjeeTarun Narang
Jun 23, 2015·Current Opinion in Infectious Diseases·Andrés F Henao-Martínez, John David Beckham
Jul 12, 2020·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Matthew M Johnson, Kiran Gajurel
Mar 5, 2015·Mycopathologia·Lin DuYuanjie Zhu
Jun 21, 2020·American Journal of Clinical Dermatology·Frank T WinsettBrent C Kelly
Jul 12, 2018·Case Reports in Infectious Diseases·Ali MonfaredSeyyede Zeinab Azimi
May 24, 2018·Current Infectious Disease Reports·Cory J PettitBenjamin Kaffenberger
Jun 18, 2020·World Journal of Hepatology·Gustavo de Sousa Arantes FerreiraGabriel Oliveira Nunes Caja
Aug 7, 2019·Journal of Fungi·Justin BeardsleySharon C-A Chen
Apr 17, 2021·Infection·A Pulido-PérezE Bouza
Jun 25, 2021·The Journal of Dermatology·Reimon YamaguchiTakashi Mochizuki
Jun 18, 2021·Respiratory Medicine·D WilmesN Kanaan
Apr 5, 2021·Mycopathologia·Yinggai SongRuoyu Li
Oct 2, 2020·Case Reports in Dermatology·Guy Shalom, Amir Horev