Title |
Pulmonary Cryptococcosis in Solid Organ Transplant Recipients: Clinical Relevance of Serum Cryptococcal Antigen
|
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Published in |
Clinical Infectious Diseases, January 2008
|
DOI | 10.1086/524738 |
Pubmed ID | |
Authors |
Nina Singh, Barbara D. Alexander, Olivier Lortholary, Françoise Dromer, Krishan L. Gupta, George T. John, Ramon del Busto, Goran B. Klintmalm, Jyoti Somani, G. Marshall Lyon, Kenneth Pursell, Valentina Stosor, Patricia Muñoz, Ajit P. Limaye, Andre C. Kalil, Timothy L. Pruett, Julia Garcia-Diaz, Atul Humar, Sally Houston, Andrew A. House, Dannah Wray, Susan Orloff, Lorraine A. Dowdy, Robert A. Fisher, Joseph Heitman, Marilyn M. Wagener, Shahid Husain |
Abstract |
The role of serum cryptococcal antigen in the diagnosis and determinants of antigen positivity in solid organ transplant (SOT) recipients with pulmonary cryptococcosis has not been fully defined. We conducted a prospective, multicenter study of SOT recipients with pulmonary cryptococcosis during 1999-2006. Forty (83%) of 48 patients with pulmonary cryptococcosis tested positive for cryptococcal antigen. Patients with concomitant extrapulmonary disease were more likely to have a positive antigen test result (P=.018), and antigen titers were higher in patients with extrapulmonary disease (P=.003) or fungemia (P=.045). Patients with single nodules were less likely to have a positive antigen test result than were those with all other radiographic presentations (P=.053). Among patients with isolated pulmonary cryptococcosis, lung transplant recipients were less likely to have positive cryptococcal antigen test results than were recipients of other types of SOT (P=.003). In all, 38% of the patients were asymptomatic or had pulmonary cryptococcosis detected as an incidental finding. Nodular densities or mass lesions were more likely to present as asymptomatic or incidentally detected pulmonary cryptococcosis than as pleural effusions and infiltrates (P=.008). A positive serum cryptococcal antigen test result in SOT recipients with pulmonary cryptococcosis appears to reflect extrapulmonary or more advanced radiographic disease. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | 100% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Argentina | 2 | 4% |
Unknown | 53 | 96% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Postgraduate | 8 | 15% |
Professor > Associate Professor | 8 | 15% |
Other | 6 | 11% |
Researcher | 6 | 11% |
Student > Master | 6 | 11% |
Other | 14 | 25% |
Unknown | 7 | 13% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 31 | 56% |
Agricultural and Biological Sciences | 5 | 9% |
Immunology and Microbiology | 5 | 9% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
Biochemistry, Genetics and Molecular Biology | 1 | 2% |
Other | 4 | 7% |
Unknown | 8 | 15% |