title: Cryptococcus neoformans Infection in Patients With Cirrhosis, Including Liver Transplant Candidates.
abstract: We reviewed the cases of patients with cirrhosis, including liver transplant candidates, at our institution in the last 3 years (n = 5) and those individually described in the literature (n = 28), to assess unique characteristics and outcome of cryptococcosis in these patients. Sixty-four percent (21/33) of the patients had no other recognized immunosuppression. Peritonitis (in 45%, 15/33 of the patients) with modest pleocytosis in the ascitic fluid, was the most common presenting feature. Median time to detection of Cryptococcus in the ascitic fluid cultures was 6 days. Overall mortality rate was 81% (26/32); death was deemed attributable to cryptococcosis in 24/26 patients who died. Evaluation of culture-negative neutrocytic ascites in febrile cirrhotic patients warrants consideration of cryptococcal peritonitis.
authors.affiliation: From Veterans Affairs Medical Center and University of Pittsburgh Medical Center, Thomas E. Starzl Transplantation Institute, Pittsburgh, Pennsylvania.
authors.forename: Nina
authors.initials: N
authors.lastname: Singh
authors.forename: Shahid
authors.initials: S
authors.lastname: Husain
authors.forename: Michael
authors.initials: M
authors.lastname: de Vera
authors.forename: Timothy
authors.initials: T
authors.lastname: Gayowski
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Cacciarelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D003453:Cryptococcosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003455:Cryptococcus neoformans / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents