Review of Risk Factors in Four Cases of Cryptococcosis After Heart Transplantation
Journal
Transplantation Proceedings
Journal Volume
40
Journal Issue
8
Pages
2614-2616
Date Issued
2008
Author(s)
Abstract
Cryptococcosis is a rare infection with high mortality in patients who have undergone heart transplantation (HT). In this study, we report four cases of the disease selected from our 328 HT cases (1.22%) between 1987 and 2007. The purpose of this study was to review risk factors for cryptococcosis after HT. Three of the four patients were men. The mean time from HT to diagnosis was 8.5 months (range, 3-17 months). Cryptococcosis was subcutaneous in one patient, systemic in one, and meningeal in two. One patient died. The Antifungal regimens included intravenous amphotericin B (amBisone) and oral fluconazole (Diflucan). Patients with diabetes mellitus or renal insufficiency, are hepatitis B carriers, have undergone repeat HT, or are receivings steroid therapy are susceptible to cryptococcosis. The recommend anticryptococcal therapy is amphotericin B, followed by oral fluconazole for at least 6 months. Early diagnosis with aggressive diagnostic techniques and a combination of therapies must be considered to reduce the risk of death in HT recipients with cryptococcosis. ? 2008.
SDGs
Other Subjects
ambisone; amphotericin B; cyclosporin; cyclosporin A; fluconazole; mycophenolic acid 2 morpholinoethyl ester; prednisone; tacrolimus; unclassified drug; adult; article; case report; clinical feature; cryptococcal meningitis; cryptococcosis; diabetes mellitus; diagnostic procedure; disease predisposition; early diagnosis; female; heart transplantation; Hepatitis B virus; human; kidney failure; male; mortality; operation duration; priority journal; risk factor; risk reduction; steroid therapy; treatment duration; virus carrier; Amphotericin B; Antifungal Agents; Cryptococcosis; Cryptococcus neoformans; Drug Therapy, Combination; Female; Fluconazole; Heart Transplantation; Humans; Immunosuppressive Agents; Male; Meningitis, Cryptococcal; Middle Aged; Postoperative Complications; Risk Factors
Type
journal article