Cryptococcus Neoformans Infection in Organ Transplant Recipients: Variables Influencing Clinical Characteristics and Outcome

Emerg Infect Dis. May-Jun 2001;7(3):375-81. doi: 10.3201/eid0703.010302.

Abstract

Unique clinical characteristics and other variables influencing the outcome of Cryptococcus neoformans infection in organ transplant recipients have not been well defined. From a review of published reports, we found that C. neoformans infection was documented in 2.8% of organ transplant recipients (overall death rate 42%). The type of primary immunosuppressive agent used in transplantation influenced the predominant clinical manifestation of cryptococcosis. Patients receiving tacrolimus were significantly less likely to have central nervous system involvement (78% versus 11%, p =0.001) and more likely to have skin, soft-tissue, and osteoarticular involvement (66% versus 21%, p = 0.006) than patients receiving nontacrolimus- based immunosuppression. Renal failure at admission was the only independently significant predictor of death in these patients (odds ratio 16.4, 95% CI 1.9-143, p = 0.004). Hypotheses based on these data may elucidate the pathogenesis and may ultimately guide the management of C. neoformans infection in organ transplant recipients.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Cryptococcosis / complications
  • Cryptococcosis / epidemiology*
  • Cryptococcosis / mortality
  • Female
  • Humans
  • Male
  • Middle Aged
  • Organ Transplantation / adverse effects*
  • Time Factors