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Primary cryptococcal cellulitis in a lung transplant recipient.

Sofie A H Van Grieken1, Lieven J Dupont, Dirk E M Van Raemdonck

  • 1Department of Respiratory Diseases, University Hospital Gasthuisberg, Leuven, Belgium.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|March 10, 2007
PubMed
Summary
This summary is machine-generated.

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Cutaneous cryptococcal infection in transplant patients can be primary, leading to disseminated disease. This case highlights cryptococcal cellulitis as a potential origin of fungal dissemination, even in the absence of initial central nervous system involvement.

Area of Science:

  • Medical Mycology
  • Transplant Infectious Diseases
  • Dermatology

Background:

  • Cutaneous cryptococcal infections in organ transplant recipients are controversial, with debate on whether they represent primary infections or disseminated disease.
  • Early diagnosis and management are crucial for improving outcomes in immunocompromised patients.

Observation:

  • A lung transplant recipient developed cryptococcal cellulitis post-operatively, with no initial signs of disseminated infection.
  • The patient received treatment including liposomal amphotericin B, fluconazole, and surgical debridement.

Findings:

  • Despite initial treatment, the patient later developed cerebral cryptococcosis, confirmed by computed tomography.
  • The clinical course suggests that the initial cryptococcal cellulitis was the primary infection site and the source of dissemination to the brain.

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Implications:

  • Cryptococcal cellulitis should be considered in the differential diagnosis of skin lesions in transplant recipients.
  • This case underscores the importance of vigilant monitoring for dissemination, even when initial presentation appears localized.
  • Prompt recognition and aggressive management of cryptococcal infections are vital in immunocompromised hosts.