@article {1497,
	title = {Cutaneous cryptococcosis in solid organ transplant recipients},
	journal = {Med Mycol},
	volume = {48},
	year = {2010},
	note = {Sun, Hsin-Yun Alexander, Barbara D Lortholary, Olivier Dromer, Francoise Forrest, Graeme N Lyon, G Marshall Somani, Jyoti Gupta, Krishan L Del Busto, Ramon Pruett, Timothy L Sifri, Costi D Limaye, Ajit P John, George T Klintmalm, Goran B Pursell, Kenneth Stosor, Valentina Morris, Michele I Dowdy, Lorraine A Munoz, Patricia Kalil, Andre C Garcia-Diaz, Julia Orloff, Susan L House, Andrew A Houston, Sally H Wray, Dannah Huprikar, Shirish Johnson, Leonard B Humar, Atul Razonable, Raymund R Fisher, Robert A Husain, Shahid Wagener, Marilyn M Singh, Nina Cryptococcal Collaborative Transplant Study Group R01 AI 054719-01/AI/NIAID NIH HHS/United States Research Support, N.I.H., Extramural England Medical mycology : official publication of the International Society for Human and Animal Mycology Med Mycol. 2010 Sep;48(6):785-91.},
	month = {Sep},
	pages = {785 - 91},
	edition = {40205},
	abstract = {Clinical manifestations, treatment, and outcomes of cutaneous cryptococcosis in solid organ transplant (SOT) recipients are not fully defined. In a prospective cohort comprising 146 SOT recipients with cryptococcosis, we describe the presentation, antifungal therapy, and outcome of cutaneous cryptococcal disease. Cutaneous cryptococcosis was documented in 26/146 (17.8\%) of the patients and manifested as nodular/mass (34.8\%), maculopapule (30.4\%), ulcer/pustule/abscess (30.4\%), and cellulitis (30.4\%) with 65.2\% of the skin lesions occurred in the lower extremities. Localized disease developed in 30.8\% (8/26), and disseminated disease in 69.2\% (18/26) with involvement of the central nervous system (88.9\%, 16/18), lung (33.3\%, 6/18), or fungemia (55.6\%, 10/18). Fluconazole (37.5\%) was employed most often for localized and lipid formulations of amphotericin B (61.1\%) for disseminated disease. Overall mortality at 90 days was 15.4\% (4/26) with 16.7\% in disseminated and 12.5\% in localized disease (P = 0.78). SOT recipients who died were more likely to have renal failure (75.0\% vs. 13.6\%, P = 0.028), longer time to onset of disease after transplantation (87.5 vs. 22.6 months, P = 0.023), and abnormal mental status (75\% vs. 13.6\%, P = 0.028) than those who survived. Cutaneous cryptococcosis represents disseminated disease in most SOT recipients and preferentially involves the extremities. Outcomes with appropriate management were comparable between SOT recipients with localized and disseminated cryptococcosis.},
	keywords = {Antifungal Agents / therapeutic use, Central Nervous System Fungal Infections / epidemiology / mortality, Cohort Studies, Cryptococcosis / complications / drug therapy / mortality / *pathology, Cryptococcus neoformans / *isolation \& purification, Dermatomycoses / complications / drug therapy / mortality / *pathology, Female, Fluconazole / therapeutic use, Fungemia / epidemiology / mortality, Humans, Lung Diseases, Fungal / epidemiology / mortality, Male, Middle Aged, Prospective Studies, Transplantation, Transplants / *adverse effects},
	issn = {1460-2709 (Electronic) 1369-3786 (Linking)},
	doi = {10.3109/13693780903496617},
	author = {Sun,H. Y. and Alexander,B. D. and Lortholary,O. and Dromer,F. and Forrest,G. N. and Lyon,G. M. and Somani,J. and Gupta,K. L. and del Busto,R. and Pruett,T. L. and Sifri,C. D. and Limaye,A. P. and John,G. T. and Klintmalm,G. B. and Pursell,K. and Stosor,V. and Morris,M. I. and Dowdy,L. A. and Munoz,P. and Kalil,A. C. and Garcia-Diaz,J. and Orloff,S. L. and House,A. A. and Houston,S. H. and Wray,D. and Huprikar,S. and Johnson,L. B. and Humar,A. and Razonable,R. R. and Fisher,R. A. and Husain,S. and Wagener,M. M. and Singh,N.}
}
