*Presented in part at the Annual Meeting of the American Academy of Neurology held in San Diego from April 29 to May 6, 2000 (abstract #P04.058).
Cryptococcal meningitis: an analysis among 5521 consecutive organ transplant recipients
Version of Record online: 15 JAN 2003
Transplant Infectious Disease
Volume 4, Issue 4, pages 183–188, December 2002
How to Cite
Wu, G., Vilchez, R.A., Eidelman, B., Fung, J., Kormos, R. and Kusne, S. (2002), Cryptococcal meningitis: an analysis among 5521 consecutive organ transplant recipients. Transplant Infectious Disease, 4: 183–188. doi: 10.1034/j.1399-3062.2002.t01-1-02005.x
Regis A. Vilchez, MD is the recipient of the Junior Faculty Development Award from GlaxoSmithKline. He is currently affiliated with the Department of Medicine, and Molecular virology and Microbiology, Baylor College of Medicine, Houston, Texas.
- Issue online: 15 JAN 2003
- Version of Record online: 15 JAN 2003
- Received 11 March 2002, revised 10 July 2002, accepted for publication 15 August 2002
- cryptococcal meningitis;
- organ transplantation;
- invasive fungal infection;
- fungal meningitis
Abstract: Cryptococcal meningitis has been reported to be an important cause of morbidity and mortality in renal transplant recipients. However, additional studies of recipients of other organ transplants suggested that these patients might be at low risk for cryptococcal meningitis. We examined the incidence and clinical features of cryptococcal meningitis among different groups of organ transplant patients at the University of Pittsburgh Medical Center. From January 1989 through July 1999, 28 patients were diagnosed with cryptococcal meningitis among 5521 transplant recipients. These included liver (11/2539), heart (8/372), kidney (7/2122), lung (1/432), and small bowel (1/56) recipients. The incidence of cryptococcal meningitis was higher in heart and small bowel recipients compared to other transplant populations (P = 0.005). The cryptococcal meningitis-related mortality in transplant recipients was 50% and was associated with altered mental status (P = 0.001), absence of headache (P = 0.02), and liver failure (P = 0.002). Multivariable analysis indicated that liver failure was the only independent risk factor for poor prognosis (P = 0.043). All cases of liver failure occurred among liver transplant recipients. Cryptococcal meningitis is associated with significant mortality among organ transplant recipients. The presence of allograft failure in liver transplant recipients with cryptococcal meningitis may be an indicator of poor prognosis in this patient population.