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Cryptococcosis after renal transplantation: report of ten cases

Schroter, GPJ and Temple, DR and Husberg, BS and Weil, R and Starzl, TE (1976) Cryptococcosis after renal transplantation: report of ten cases. Surgery, 79 (3). 268 - 277. ISSN 0039-6060

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Abstract

Ten cases of cryptococcosis have been identified in a 13 year experience with more than 650 renal transplants. Eight patients had meningitis, one patient had a cerebral granuloma, and in one patient the infection appeared to be limited to the lungs. The central nervous system infection often masqueraded as brain tumor and was not suspected initially. The most useful diagnostic test was cerebrospinal fluid examination including India ink preparation. Various therapeutic regimens with amphotericin B and 5 fluorocytosine were effective in suppressing the infection. A combination of low doses of amphotericin B, not affecting kidney function, with 5 fluorocytosine for at least 3 months was associated with remission of disease in five patients who still are alive, including three patients without recurrence for longer than one year. Five deaths 3 weeks to 4 years after the beginning of treatment were not due to cryptococcosis; death resulted from vascular disease and septicemia in three of the four patients with known causes of death. Central nervous system cryptococcosis, with the exception of the rare cerebral granuloma, is associated with little inflammation. If early death from increased intracranial pressure or cerebral edema is prevented, prolonged therapy with amphotericin B and 5 fluorocytosine may be expected to control the infection, even in immunosuppressed patients.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Schroter, GPJ
Temple, DR
Husberg, BS
Weil, R
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 December 1976
Date Type: Publication
Journal or Publication Title: Surgery
Volume: 79
Number: 3
Page Range: 268 - 277
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0039-6060
Other ID: uls-drl:31735062109651, Starzl CV No. 364
Date Deposited: 08 Apr 2010 17:06
Last Modified: 13 Oct 2017 21:55
URI: http://d-scholarship.pitt.edu/id/eprint/3750

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