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Related Experiment Videos

[Late cryptococcal meningitis after liver transplantation].

J Dumortier1, M A Piens, O Boillot

  • 1INSERM Unité 45, Hôpital Edouard-Herriot, Lyon.

Gastroenterologie Clinique Et Biologique
|January 5, 2000
PubMed
Summary

This case study highlights cryptococcal meningitis in a liver transplant recipient. Long-term oral fluconazole is effective for preventing relapse after cryptococcal antigen detection.

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Area of Science:

  • Immunology
  • Infectious Diseases
  • Hepatology

Background:

  • Liver transplantation is a life-saving procedure for end-stage liver disease.
  • Primary biliary cirrhosis is a common indication for liver transplantation.
  • Immunosuppression post-transplantation increases susceptibility to opportunistic infections.

Observation:

  • A patient developed cryptococcal meningitis eight years after liver transplantation for primary biliary cirrhosis.
  • Cryptococcal antigen detection in serum and cerebrospinal fluid was crucial for diagnosis.
  • The patient was treated with long-term oral fluconazole.

Findings:

  • Early detection of cryptococcal antigen is vital for diagnosing cryptococcal meningitis.
  • Sustained oral fluconazole monotherapy can effectively prevent relapse.

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  • This case underscores the importance of monitoring for opportunistic infections years after transplantation.

    • Implications:

    • Clinicians should maintain a high index of suspicion for opportunistic infections in long-term liver transplant survivors.
    • Monitoring cryptococcal antigen levels aids in managing and preventing recurrent cryptococcal meningitis.
    • Extended prophylactic or therapeutic fluconazole regimens may be necessary in select immunosuppressed patients.