A clinical analysis of renal transplant patients with cryptococcal meningitis

Abstract

Abstract: Objective To analysis the clinical features of renal transplant patients with cryptococcal meningitis, and the difficulties of the diagnosis and treatment.Methods Four patients with cryptococcal meningitis after renal transplantation were involved in this study.The clinical manifestations,laboratory data,treatment and prognosis were analyzed.Results Four patients,2 male and 2 female, were underwent renal transplantation for the first time.The clinical manifestations included headache and fever.Three patients were confirmed cryptococcal meningitis by CSF culture and means of India ink. All patients were given antifungal treatment of amphotericin B liposome, voriconazole, and 5-flucytosine, while 1 patient was given amphotericin B intrathecal injection. After 2-4 months treatment, the results of cryptococcus smear turned negative, and clinical symptoms disappeared in 4 patients. Now all the 4 patients are still in follow-up, and there are no relapse.Conclusions Renal transplant patients with cryptococcal meningitis presented atypical clinical manifestations, which made it extremely difficult to diagnosis. Early diagnosis,timely treatment,and cooperation between different departments are the key to improve outcomes.

Key words: renal transplant, cryptococcal meningitis, cryptococcosis

CLC Number:

R519.4

YANG Ya-li, DU Lin, WEN Hai, ZHU Fan-yuan, FANG Wei, ZHU Yuan-jie, GU Ju-lin, CHEN Jiang-han, LIAO Wan-qing. A clinical analysis of renal transplant patients with cryptococcal meningitis[J]. Chinese Journal of Mycology, 2013, 8(2): 78-82.

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