Comparison of different therapeutic approaches for pulmonary cryptococcosis in kidney transplant recipients: a 15-year retrospective analysis

作者全名："Chen, Shuyang; Yu, Guoqing; Chen, Meiyan; You, Yanjing; Gu, Lei; Wang, Qing; Wang, Huijuan; Lai, Guoxiang; Yu, Zongyang; Wen, Wen"

作者地址："[Chen, Shuyang; Chen, Meiyan; You, Yanjing; Wang, Huijuan; Lai, Guoxiang; Yu, Zongyang; Wen, Wen] Fujian Med Univ, Xiamen Univ, Hosp Joint Logist Support Force 900, Dept Resp & Crit Care Med,Fuzhou Gen Hosp,Dongfang, Fuzhou, Peoples R China; [Chen, Shuyang] Fudan Univ, Zhongshan Hosp, Dept Pulm & Crit Care Med, Shanghai, Peoples R China; [Yu, Guoqing] Fujian Med Univ, Xiamen Univ, Hosp Joint Logist Support Force 900, Dept Nephrol,Fuzhou Gen Hosp,Dongfang Hosp, Fuzhou, Peoples R China; [Gu, Lei] Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China; [Wang, Qing] Fujian Univ Tradit Chinese Med, Affiliated Peoples Hosp 3, Fuzhou, Peoples R China"

通信作者："Wen, W (通讯作者)，Fujian Med Univ, Xiamen Univ, Hosp Joint Logist Support Force 900, Dept Resp & Crit Care Med,Fuzhou Gen Hosp,Dongfang, Fuzhou, Peoples R China."

来源：FRONTIERS IN MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001030194700001

JCR分区：Q1

影响因子：3.1

年份：2023

卷号：10

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：pulmonary cryptococcosis; post-transplant infection; invasive fungal infection; antifungal therapy; radiographic abnormalities

摘要："IntroductionOrgan transplant recipients are at increased risk of developing pulmonary cryptococcosis (PC) due to weakened cell-mediated immunity caused by immunosuppressors. However, the nonspecific symptoms associated with PC can often lead to misdiagnosis and inappropriate treatment. MethodsWe conducted a retrospective analysis of data from 23 kidney transplant recipients with PC between April 2006 to January 2021. ResultsThe median time from transplantation to the diagnosis of pathology-proven PC 4.09 years. Seventeen patients presented respiratory symptoms, including sputum-producing cough and dyspnea. Additionally, three patients also developed central nervous system (CNS) infections. Chest CT scans frequently revealed nodule-shaped lesions, which can mimic lung carcinoma. Serological tests did not demonstrate any specific changes. Nine patients received surgical resection as treatment. Fourteen patients were treated with antifungal medication only. No recurrence was observed in all 23 patients. ConclusionOur study suggests that fever and sputum-producing cough are common symptoms of PC, and cryptococcal meningitis should not be excluded if corresponding symptoms occur. Fluconazole is a common and effective antifungal agent. Surgical resection should be considered for patients who do not respond well to antifungal therapy. Clinicians should be aware of these findings when evaluating transplant recipients with respiratory symptoms."

基金机构：Fujian Scientific Innovation Joint Funding [2020Y9042]

基金资助正文：Funding This research was supported by Fujian Scientific Innovation Joint Funding (2020Y9042 to WW).