Unrecognized pretransplant and donor‐derived cryptococcal disease in organ transplant recipients.

dc.contributor.author

Sun, HY

dc.contributor.author

Alexander, BD

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Lortholary, O

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Dromer, F

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Forrest, GN

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Lyon, GM

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Somani, J

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Gupta, KL

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Busto, R del

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Pruett, TL

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Sifri, CD

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Limaye, AP

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John, GT

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Klintmalm, GB

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Pursell, K

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Stosor, V

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Morris, MI

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Dowdy, LA

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Munoz, P

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Kalil, AC

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Garcia-Diaz, J

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Orloff, SL

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House, AA

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Houston, SH

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Wray, D

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Huprikar, S

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Johnson, LB

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Humar, A

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Razonable, RR

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Fisher, RA

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Husain, S

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Wagener, MM

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Singh, N

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Group, Cryptococcal Collaborative Transplant Study

dc.coverage.spatial

United States

dc.date.accessioned

2011-06-21T17:27:22Z

dc.date.issued

2010-11-01

dc.description.abstract

BACKGROUND: Cryptococcosis occurring ≤30 days after transplantation is an unusual event, and its characteristics are not known. METHODS: Patients included 175 solid-organ transplant (SOT) recipients with cryptococcosis in a multicenter cohort. Very early-onset and late-onset cryptococcosis were defined as disease occurring ≤30 days or >30 days after transplantation, respectively. RESULTS: Very early-onset disease developed in 9 (5%) of the 175 patients at a mean of 5.7 days after transplantation. Overall, 55.6% (5 of 9) of the patients with very early-onset disease versus 25.9% (43 of 166) of the patients with late-onset disease were liver transplant recipients (P = .05). Very early cases were more likely to present with disease at unusual locations, including transplanted allograft and surgical fossa/site infections (55.6% vs 7.2%; P < .001). Two very early cases with onset on day 1 after transplantation (in a liver transplant recipient with Cryptococcus isolated from the lung and a heart transplant recipient with fungemia) likely were the result of undetected pretransplant disease. An additional 5 cases involving the allograft or surgical sites were likely the result of donor‐acquired infection. CONCLUSIONS: A subset of SOT recipients with cryptococcosis present very early after transplantation with disease that appears to occur preferentially in liver transplant recipients and involves unusual sites, such as the transplanted organ or the surgical site. These patients may have unrecognized pretransplant or donor-derived cryptococcosis.

dc.description.version

Version of Record

dc.identifier

http://www.ncbi.nlm.nih.gov/pubmed/20879857

dc.identifier.eissn

1537-6591

dc.identifier.uri

https://hdl.handle.net/10161/4161

dc.language

eng

dc.language.iso

en_US

dc.publisher

Oxford University Press (OUP)

dc.relation.ispartof

Clin Infect Dis

dc.relation.isversionof

10.1086/656584

dc.relation.journal

Clinical Infectious Diseases

dc.subject

Adult

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Aged

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Cohort Studies

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Cryptococcosis

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Cryptococcus

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Female

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Humans

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Male

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Middle Aged

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Postoperative Complications

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Time Factors

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Tissue Donors

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Transplants

dc.title

Unrecognized pretransplant and donor‐derived cryptococcal disease in organ transplant recipients.

dc.title.alternative
dc.type

Journal article

duke.date.pubdate

2010-11-1

duke.description.issue

9

duke.description.volume

51

pubs.author-url

http://www.ncbi.nlm.nih.gov/pubmed/20879857

pubs.begin-page

1062

pubs.end-page

1069

pubs.issue

9

pubs.organisational-group

Clinical Science Departments

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Duke

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Medicine

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Medicine, Infectious Diseases

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Pathology

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School of Medicine

pubs.publication-status

Published

pubs.volume

51

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