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Donor-derived Cryptococcus gattii complex infection after liver transplantation
Bruno Hassunuma Carneiro1,2, Giovanni Luis Breda1, Regielly Caroline Raimundo Cognialli1
1Universidade Federal do Paraná, Hospital de Clínicas, Curitiba, PR, Brasil.
Abstract:
Cryptococcal disease is the third most common invasive fungal infection in solid organ transplant recipients and is associated with high-morbidity and -mortality rates. Donor-derived Cryptococcus spp. infection typically manifests within the first month post-procedure and has historically been caused by C. neoformans complex, predominantly in kidney recipients, but also after liver transplantation. We report the first documented case of donor-derived, early-onset C. gattii complex meningoencephalitis following liver transplantation in a 54-year-old woman, successfully treated with amphotericin B and fluconazole, and review the relevant literature.
Insights
This study details the first case of donor-derived Cryptococcus gattii meningoencephalitis after liver transplant. Early diagnosis and treatment with amphotericin B and fluconazole led to successful outcomes.
Area of Science:
- Infectious Diseases
- Transplantation Medicine
- Mycology
Background:
- Cryptococcal disease is a significant cause of morbidity and mortality in solid organ transplant recipients.
- Donor-derived Cryptococcus spp. infections typically occur within the first month post-transplant.
- Historically, C. neoformans complex has been the predominant cause, particularly in kidney and liver transplant recipients.
Purpose of the Study:
- To report the first case of donor-derived Cryptococcus gattii complex meningoencephalitis in a liver transplant recipient.
- To describe the successful treatment of this rare complication.
- To review existing literature on donor-derived cryptococcal infections in transplant patients.
Main Methods:
- Case report of a 54-year-old female liver transplant recipient.
- Diagnosis of meningoencephalitis caused by C. gattii complex.
- Treatment with amphotericin B and fluconazole.
- Literature review of donor-derived cryptococcal infections.
Main Results:
- The patient developed early-onset meningoencephalitis attributed to donor-derived C. gattii.
- Successful treatment was achieved with a combination of amphotericin B and fluconazole.
- This represents the first documented case of its kind in a liver transplant recipient.
Conclusions:
- Donor-derived C. gattii complex infection is a rare but serious complication following liver transplantation.
- Prompt diagnosis and appropriate antifungal therapy are crucial for favorable outcomes.
- Awareness of this potential transmission route is important for transplant clinicians.
