Dynamic research of serum cryptococcal capsular polysaccharide antigen test and chest CT of pulmonary cryptococcosis without HIV

Li, Yuping; Lin, Pengcheng; Ye, Junru; Chen, Chengshui

doi:10.1183/13993003.congress-2019.pa4569

Cited by 2 publications

(2 citation statements)

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“…Previous physicians observed the dynamic changes in pulmonary cryptococcal infection and concluded from chest CT that the size of the infection sites usually reduced 67.9% 6 months into antifungal therapy. [21] IDSA guidelines also suggest a sequential or step-wise reduction of immunosuppressants, suggesting the dose of the corticosteroid to be lowered first. While further clinical studies should be performed to further validate the effectiveness of these suggestions, it is of great necessity to determine whether immunosuppressants influence the pharmaceutical effects of the antifungal therapy.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Pulmonary Cryptococcosis Following Kidney Transplantation: Clinical Presentation, Treatment and Effectiveness

Chen

CHEN

et al. 2022

Preprint

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Background: The use of immunosuppressors and a relatively weakened cell-mediated immunity makes organ transplant recipients particularly vulnerable to cryptococcosis infection. Patients infected usually present only nonspecific symptoms, making it extremely possible for misdiagnosis and inappropriate choice of therapeutic approaches.Methods: We compiled and analyzed data of patients who received kidney transplant in our hospital between April 2006 to January 2021.Results: 18 patients were enrolled in the study, ranging between 27-68 years old. The median time from kidney transplantation to pathologically-confirmed infection was 4.09 years. All patients’ respiratory system was affected, showing symptoms including sputum-producing cough and fever. 3 patients (16.67%) also developed central nervous system (CNS) infections. Nodule-shaped infectious sites were frequently observed (10, 58.82%) in chest CT. Blood works showed no specific changes. 7 patients received thoracoscopic lobectomy in suspicion of lung cancer. 3 patients first received antifungal therapy for a period of time and then underwent thoracoscopic lobectomy. No recurrence whatsoever was observed in all 10 surgically-intervened patients. 8 patients received only antifungal therapy, 7 of them showed a substantial reduction in the size of the infectious site. Fluconazole was most frequently prescribed for antifungal therapy. Conclusion: Most patients developed pulmonary cryptococcosis 2 years after transplantation. Patients usually demonstrate symptoms like fever and sputum-producing cough. The possibility of cryptococcal meningitis shouldn’t be ruled out if corresponding symptoms occur. CT presentation may be confused with lung cancer. Fluconazole is commonly prescribed for treatment and can usually yield satisfactory outcomes. In patients who received unsatisfactory antifungal therapy, surgical therapy should be considered a possibility.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Pulmonary Cryptococcosis Following Kidney Transplantation: Clinical Presentation, Treatment and Effectiveness

Chen

CHEN

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Previous physicians observed the dynamic changes in pulmonary cryptococcal infection and concluded from chest CT that the size of the infection sites usually reduced 67.9% 6 months into antifungal therapy. [20] IDSA guidelines also suggest sequential or step-wise reduction of immunosuppressants, suggesting the dose of corticosteroid be lowered first. While further clinical studies should be performed to further validate the effectiveness of this suggestions, it is of great necessity to determine whether immunosuppressants influence the pharmaceutical effects of the antifungal therapy.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Pulmonary Cryptococcosis Following Kidney Transplantation: Clinical Presentation, Treatment and Effectiveness

Chen¹,

Chen²,

Gu³

et al. 2021

Preprint

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Background: The use of immunosuppressors and a relatively weaken cell-mediated immunity make organ transplant recipients particularly vulnerable to cryptococcosis infection. Patients infected usually present only nonspecific symptoms, making it extremely possible for misdiagnosis and inappropriate choice of therapeutic approach. Methods: We compiled and analysed data of patients received kidney transplant in our hospital between April 2006 to January 2021. Results: 18 patients were enrolled into the study, ranging between 27-68 years old. The median time from kidney transplantation to pathologically-confirmed infection was 4.09 years. All patient’s respiratory system was affected, showing symptoms including sputum-producing cough and fever. 3 patients (16.67%) also developed central nervous system (CNS) infections. Nodule-shaped infectious sites were frequently observed (10, 58.82%) in chest CT. Blood works showed no specific changes. 7 patients received thoracoscopic lobectomy in suspicion of lung cancer. 3 patients first received antifungal therapy for a period of time and then underwent thoracoscopic lobectomy. No recurrence whatsoever was observed in all 10 surgically-intervened patients. 8 patients received only antifungal therapy, 7 of them showed a substantial reduction in the size of the infectious site. Fluconazole was most frequently prescribed for antifungal therapy. Conclusion: Most patients developed pulmonary cryptococcosis 2 years after transplantation. Patients usually demonstrate symptoms like fever and sputum-producing cough. The possibility of cryptococcal meningitis shouldn’t be ruled out if corresponding symptoms occur. CT presentation may be confused with lung cancer. Fluconazole is commonly prescribed for treatment and can usually yield satisfied outcome. In patients received unsatisfactory antifungal therapy, surgical therapy should be considered a possibility.

show abstract

Dynamic research of serum cryptococcal capsular polysaccharide antigen test and chest CT of pulmonary cryptococcosis without HIV

Cited by 2 publications

References 0 publications

A Retrospective Analysis of Pulmonary Cryptococcosis Following Kidney Transplantation: Clinical Presentation, Treatment and Effectiveness

A Retrospective Analysis of Pulmonary Cryptococcosis Following Kidney Transplantation: Clinical Presentation, Treatment and Effectiveness

A Retrospective Analysis of Pulmonary Cryptococcosis Following Kidney Transplantation: Clinical Presentation, Treatment and Effectiveness

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