title: [Invasive yeast diseases in solid organ transplant recipients].
abstract: Invasive yeast diseases are uncommon nowadays in solid organ transplant recipients. Invasive candidiasis (2%) usually presents during the first month after transplantation in patients with risk factors. Both common and transplant-specific risk factors have been identified, allowing very efficacious targeted prophylaxis strategies. The most common clinical presentations are fungaemia and local infections near the transplantation area. Cryptococcosis is usually a late infection. Its incidence remains stable and the specific risk factors have not been identified. When cryptococcosis is detected very early, transmission with the allograft should be considered. The most common clinical presentations include meningitis, pneumonia, and disseminated infection. Intracranial hypertension and immune reconstitution syndrome have to be considered. No therapeutic clinical trials have been conducted in solid organ transplant recipients, thus treatment recommendations are derived from data obtained from the general population. It is particularly important to consider the possibility of drug-drug interactions, mainly between azoles and calcineurin inhibitors. Both invasive candidiasis and cryptococcosis increase the mortality significantly in solid organ transplant recipients.
authors.affiliation: Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación Sanitaria, Hospital Gregorio Marañón, Madrid, España; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España. Electronic address: pmunoz@hggm.es.
authors.forename: Patricia
authors.initials: P
authors.lastname: Muñoz
authors.affiliation: Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: José María
authors.initials: JM
authors.lastname: Aguado
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D058365:Candidiasis, Invasive / Q000175:diagnosis / Q000188:drug therapy; D003453:Cryptococcosis / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D000072742:Invasive Fungal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D016377:Organ Transplantation; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D017410:Practice Guidelines as Topic; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents
keywords: Candida; Candidiasis invasora; Cryptococcus; Immunosuppressed patients; Invasive candidiasis; Paciente inmunodeprimido; Transplantation; Trasplante