Comparison of different therapeutic approaches for pulmonary cryptococcosis in kidney transplant recipients: a 15-year retrospective analysis
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 cond...
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1107330/full |
| _version_ | 1827906080264421376 |
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| author | Shuyang Chen Shuyang Chen Guoqing Yu Meiyan Chen Yanjing You Lei Gu Qing Wang Huijuan Wang Guoxiang Lai Zongyang Yu Wen Wen |
| author_facet | Shuyang Chen Shuyang Chen Guoqing Yu Meiyan Chen Yanjing You Lei Gu Qing Wang Huijuan Wang Guoxiang Lai Zongyang Yu Wen Wen |
| author_sort | Shuyang Chen |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-13T00:51:35Z |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-13T00:51:35Z |
| publishDate | 2023-07-01 |
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| spelling | doaj.art-bada417642ef4521baeea3bb81cfeefd2023-07-07T13:35:26ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-07-011010.3389/fmed.2023.11073301107330Comparison of different therapeutic approaches for pulmonary cryptococcosis in kidney transplant recipients: a 15-year retrospective analysisShuyang Chen0Shuyang Chen1Guoqing Yu2Meiyan Chen3Yanjing You4Lei Gu5Qing Wang6Huijuan Wang7Guoxiang Lai8Zongyang Yu9Wen Wen10Department of Respiratory and Critical Care Medicine, Fuzhou General Hospital of Fujian Medical University, Dongfang Hospital of Xiamen University, The 900th Hospital of the Joint Logistic Support Force, Fuzhou, ChinaDepartment of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Nephrology, Fuzhou General Hospital of Fujian Medical University, Dongfang Hospital of Xiamen University, The 900th Hospital of the Joint Logistic Support Force, Fuzhou, ChinaDepartment of Respiratory and Critical Care Medicine, Fuzhou General Hospital of Fujian Medical University, Dongfang Hospital of Xiamen University, The 900th Hospital of the Joint Logistic Support Force, Fuzhou, ChinaDepartment of Respiratory and Critical Care Medicine, Fuzhou General Hospital of Fujian Medical University, Dongfang Hospital of Xiamen University, The 900th Hospital of the Joint Logistic Support Force, Fuzhou, ChinaThe First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaThe Third Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, ChinaDepartment of Respiratory and Critical Care Medicine, Fuzhou General Hospital of Fujian Medical University, Dongfang Hospital of Xiamen University, The 900th Hospital of the Joint Logistic Support Force, Fuzhou, ChinaDepartment of Respiratory and Critical Care Medicine, Fuzhou General Hospital of Fujian Medical University, Dongfang Hospital of Xiamen University, The 900th Hospital of the Joint Logistic Support Force, Fuzhou, ChinaDepartment of Respiratory and Critical Care Medicine, Fuzhou General Hospital of Fujian Medical University, Dongfang Hospital of Xiamen University, The 900th Hospital of the Joint Logistic Support Force, Fuzhou, ChinaDepartment of Respiratory and Critical Care Medicine, Fuzhou General Hospital of Fujian Medical University, Dongfang Hospital of Xiamen University, The 900th Hospital of the Joint Logistic Support Force, Fuzhou, ChinaIntroductionOrgan 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.https://www.frontiersin.org/articles/10.3389/fmed.2023.1107330/fullpulmonary cryptococcosispost-transplant infectioninvasive fungal infectionantifungal therapyradiographic abnormalities |
| spellingShingle | Shuyang Chen Shuyang Chen Guoqing Yu Meiyan Chen Yanjing You Lei Gu Qing Wang Huijuan Wang Guoxiang Lai Zongyang Yu Wen Wen Comparison of different therapeutic approaches for pulmonary cryptococcosis in kidney transplant recipients: a 15-year retrospective analysis Frontiers in Medicine pulmonary cryptococcosis post-transplant infection invasive fungal infection antifungal therapy radiographic abnormalities |
| title | Comparison of different therapeutic approaches for pulmonary cryptococcosis in kidney transplant recipients: a 15-year retrospective analysis |
| title_full | Comparison of different therapeutic approaches for pulmonary cryptococcosis in kidney transplant recipients: a 15-year retrospective analysis |
| title_fullStr | Comparison of different therapeutic approaches for pulmonary cryptococcosis in kidney transplant recipients: a 15-year retrospective analysis |
| title_full_unstemmed | Comparison of different therapeutic approaches for pulmonary cryptococcosis in kidney transplant recipients: a 15-year retrospective analysis |
| title_short | Comparison of different therapeutic approaches for pulmonary cryptococcosis in kidney transplant recipients: a 15-year retrospective analysis |
| title_sort | comparison of different therapeutic approaches for pulmonary cryptococcosis in kidney transplant recipients a 15 year retrospective analysis |
| topic | pulmonary cryptococcosis post-transplant infection invasive fungal infection antifungal therapy radiographic abnormalities |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1107330/full |
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