Geographic differences in disease expression of cryptococcosis in solid organ transplant recipients in the United States

TitleGeographic differences in disease expression of cryptococcosis in solid organ transplant recipients in the United States
Publication TypeJournal Article
Year of Publication2010
AuthorsOsawa R, Alexander BD, Forrest GN, Lyon GM, Somani J, del Busto R, Pruett TL, Sifri CD, Limaye AP, Klintmalm GB, Pursell K, Stosor V, Morris MI, Dowdy LA, Kalil AC, Garcia-Diaz J, Orloff SL, Houston SH, Wray D, Huprikar S, Johnson LB, Razonable RR, Fisher RA, Wagener MM, Husain S, Singh N
JournalAnn Transplant
Volume15
Issue4
Pagination77 - 83
Date PublishedDec 22
ISSN1425-9524 (Print) 1425-9524 (Linking)
Accession Number21183881
Abstract

BACKGROUND: Whether there are geographic differences in clinical presentation of cryptococcosis in solid organ transplant (SOT) recipients in the United States (US) is not known. MATERIAL/METHODS: Patients comprised a cohort of 120 SOT recipients from US transplant centers who fulfilled the EORTC/MSG criteria for cryptococcal disease. RESULTS: Central nervous system, pulmonary, and cutaneous cryptococcal disease were observed in 51% (61/120), 64% (77/120), and 15% (18/120) of the patients, respectively. Cutaneous disease was documented in 9% (3/32) of the patients from South Atlantic region, 19% (6/32) from Mid Atlantic, 26% (6/23) from Southern, 7% (2/29) from Midwestern, and in 1 of 4 patients from the Northwestern region of the US. When controlled for age, immunosuppressive regimen, type of transplant, and renal failure at baseline, patients from the Southern compared with other regions of the US were significantly more likely to have cutaneous cryptococcal disease (OR 3.8, 95% CI 1.1-14, P=0.045). CONCLUSIONS: Post-transplant cryptococcosis is more likely to present with cutaneous disease in the Southern region compared with other regions in the US. This predilection for cutaneous cryptococcosis could not be explained on the basis of differences in immunosuppression or the type of transplant. Whether our findings are related to strain-related variations in characteristics of the yeast or other transplant variables remains to be determined.

DOI
Short TitleGeographic differences in disease expression of cryptococcosis in solid organ transplant recipients in the United States
Notify Library Reference ID1110

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