https://scholars.lib.ntu.edu.tw/handle/123456789/535395
標題: | Cutaneous cryptococcosis in solid organ transplant recipients | 作者: | HSIN-YUN SUN Alexander B.D. Lortholary O. Dromer F. Forrest G.N. Lyon G.M. Somani J. Gupta K.L. Busto R.D. Pruett T.L. Sifri C.D. Limaye A.P. John G.T. Klintmalm G.B. Pursell K. Stosor V. Morris M.I. Dowdy L.A. Muoz P. Kalil A.C. Garcia-Diaz J. Orloff S.L. House A.A. Houston S.H. Wray D. Huprikar S. Johnson L.B. Humar A. Razonable R.R. Fisher R.A. Husain S. Wagener M.M. Singh N. |
公開日期: | 2010 | 出版社: | Oxford University Press | 卷: | 48 | 期: | 6 | 起(迄)頁: | 785-791 | 來源出版物: | Medical Mycology | 摘要: | 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 0.028) than those who survived. Cutaneous cryptococcosis represents disseminated disease in most SOT recipients and preferentially involves the extremities. Outcomes with appropriate management were comparable between SOT recipients with localized and disseminated cryptococcosis. ? 2010 ISHAM. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-77955867192&doi=10.3109%2f13693780903496617&partnerID=40&md5=45e756faa1b226d4a498da89f0b1e63a https://scholars.lib.ntu.edu.tw/handle/123456789/535395 |
ISSN: | 1369-3786 | DOI: | 10.3109/13693780903496617 | SDG/關鍵字: | amphotericin B deoxycholate; amphotericin B lipid complex; fluconazole; flucytosine; fungus antigen; adult; article; cellulitis; central nervous system infection; Cryptococcus; cutaneous cryptococcosis; female; fungemia; graft recipient; human; human tissue; kidney failure; lung infection; maculopapular rash; major clinical study; male; mental instability; mortality; postoperative infection; prospective study; pustule; skin abscess; skin nodule; skin ulcer; survival; systemic mycosis; treatment outcome; vesicular rash |
顯示於: | 醫學系 |
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