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[Disseminated cryptococosis in renal transplant recipient]
L Fernández Rodriguez1, R Amann, E Verde
1Servicio de Nefrología, Hospital General Universitario "Gregorio Marañón", Madrid, España.
Summary
Cryptococcosis, a fungal infection, can cause meningitis in kidney transplant patients. Early diagnosis and treatment are crucial for better outcomes in these immunocompromised individuals.
Area of Science:
- Nephrology
- Infectious Diseases
- Neurology
Background:
- Renal transplant recipients have a 0.4-5.8% incidence of cryptococcosis.
- Meningitis is a common clinical manifestation, often with a subacute course.
- Disseminated cryptococcosis is more frequent in this patient population.
Observation:
- A 32-year-old female renal transplant recipient presented with altered mental status, headache, and tremor.
- Cerebrospinal fluid analysis revealed Cryptococcus isolation.
- The patient developed refractory increased intracranial pressure, necessitating a lumboperitoneal shunt.
Findings:
- Cryptococcus was successfully isolated from cerebrospinal fluid.
- Treatment involved amphotericin B and 5-flucytosine.
- Refractory increased intracranial pressure required surgical intervention.
Implications:
- Cryptococcosis should be considered in renal transplant patients presenting with meningitis.
- Prompt diagnosis and timely treatment are essential to reduce high mortality rates.
- This case highlights the importance of vigilance for opportunistic infections in transplant recipients.