Disseminated cryptococcosis in a child with liver transplantation: a case report

Background. Cryptococcus neoformans causes cryptococcosis, primarily affecting immunocompromised individuals, including solid-organ transplant recipients, and, less frequently, immunocompetent people. Case. A 15-year-old male with congenital hepatic fibrosis, portal hypertension, and cirrhosis under...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The Turkish journal of pediatrics Jg. 66; H. 4; S. 499 - 504
Hauptverfasser: Barut, Doğan, Kunay, Bora, Yıldırım Arslan, Sema, Akkuş, Gözde Kayalı, Şahbudak Bal, Zümrüt, Yazıcı, Pınar, Karakoyun, Miray, Aydoğdu, Sema
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Turkey Akdema Informatics and Publishing 07.10.2024
Hacettepe University Faculty of Medicine
Hacettepe University Institute of Child Health
Schlagworte:
Adolescent
Anti-Infective Agents - therapeutic use
Antifungal agents
Antifungal Agents - therapeutic use
Blood
Congenital diseases
Consent
Cryptococcal infections
cryptococcosis
Cryptococcosis - complications
Cryptococcosis - drug therapy
Cryptococcus neoformans
Development and progression
Disease prevention
Fatal Outcome
Fluconazole
Fluconazole - therapeutic use
Fungal infections
Gastrointestinal Hemorrhage - microbiology
Hemoglobin
Humans
Hypertension
Hypertension, Portal - congenital
Hypertension, Portal - microbiology
Hypertension, Portal - surgery
Hypoxia
Hypoxia - microbiology
Immunocompetence
Immunocompromised Host
immunocompromised patients
Ischemia
Kidney transplants
Laboratories
Leukocytes
Liver
Liver cirrhosis
Liver Cirrhosis - congenital
Liver Cirrhosis - microbiology
Liver Cirrhosis - surgery
liver transplantation
Liver Transplantation - adverse effects
Liver transplants
Lymphadenitis - microbiology
Magnetic resonance imaging
Male
Medical examination
Meningitis
Meningitis, Fungal - microbiology
Mortality
Organ transplant recipients
Pancreatitis
Pancreatitis - microbiology
Patients
Pediatrics
Perioperative Care
Pneumonia
Pneumonia - microbiology
Polymerase chain reaction
Postoperative Complications - microbiology
Postoperative Complications - prevention & control
Respiratory failure
Tazobactam
Transplantation
Viruses
Yeast
immunocompromised patients
cryptococcosis
liver transplantation
ISSN:0041-4301, 2791-6421, 2791-6421
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Background. Cryptococcus neoformans causes cryptococcosis, primarily affecting immunocompromised individuals, including solid-organ transplant recipients, and, less frequently, immunocompetent people. Case. A 15-year-old male with congenital hepatic fibrosis, portal hypertension, and cirrhosis underwent orthotopic liver transplantation. He received perioperative antimicrobial and antifungal prophylaxis and continued immunosuppressive treatment. Thirty months post-transplant, he presented with fever, hypertension, and sacroiliac joint pain. Peripheral blood cultures showed C. neoformans, confirmed by pan-fungal polymerase chain reaction assay and latex agglutination tests. Despite initial treatment with intravenous (IV) fluconazole, his condition worsened, necessitating intubation for acute hypoxic respiratory failure. Magnetic resonance imaging and computed tomography scans indicated disseminated cryptococcosis with lymphadenitis, possible meningitis, and pneumonia. Treatment was escalated to IV liposomal amphotericin B and 5-flucytosine, while reducing immunosuppressive treatment. Despite negative fungal cultures on the tenth day, the patient deteriorated, developing pancreatitis, pneumonia, and massive gastrointestinal bleeding, leading to death on the 35th day of hospitalization. Conclusion. This case shows the severity and complexity of managing disseminated cryptococcosis in pediatric liver transplant recipients. Aggressive therapy and early identification are essential for improving outcomes in these high-risk patients.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
ObjectType-Case Study-2
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
ISSN:0041-4301
2791-6421
2791-6421
DOI:10.24953/turkjpediatr.2024.4817