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Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France
Cryptococcosis is the third most common cause of invasive fungal infection in solid organ transplant recipients and cryptococcal meningitis (CM) its main clinical presentation. CM outcomes, as well as its clinical features and radiological characteristics, have not yet been considered on a large sca...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227085/ https://www.ncbi.nlm.nih.gov/pubmed/35745553 http://dx.doi.org/10.3390/pathogens11060699 |
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author | Tardieu, Laurène Divard, Gillian Lortholary, Olivier Scemla, Anne Rondeau, Éric Accoceberry, Isabelle Agbonon, Rémi Alanio, Alexandre Angoulvant, Adela Albano, Laetitia Attias, Philippe Bellanger, Anne Pauline Bertrand, Dominique Bonhomme, Julie Botterel, Françoise Bouvier, Nicolas Buchler, Matthias Chouaki, Taieb Crépin, Thomas Durieux, Marie-Fleur Desoubeaux, Guillaume Doppelt, Gary Favennec, Loïc Fekkar, Arnaud Fourdinier, Ophélie Frimat, Marie Gangneux, Jean-Pierre Garandeau, Claire Hasseine, Lilia Hennequin, Christophe Iriart, Xavier Kamar, Nassim Kaminski, Hannah Kormann, Raphael Lachaud, Laurence Legendre, Christophe Le Quintrec Donnette, Moglie Leroy, Jordan Levi, Charlène Machouart, Marie Marx, David Menotti, Jean Moal, Valérie Morio, Florent Mrozek, Natacha Nicolas, Muriel Poirier, Philippe Peraldi, Marie-Noelle Poussot, Benjamin Ranque, Stéphane Rerolle, Jean-Philippe Sendid, Boualem Snanoudj, Renaud Tourret, Jérôme Vasse, Marc Vigneau, Cécile Villard, Odile Mesnard, Laurent Lanternier, Fanny Rafat, Cédric |
author_facet | Tardieu, Laurène Divard, Gillian Lortholary, Olivier Scemla, Anne Rondeau, Éric Accoceberry, Isabelle Agbonon, Rémi Alanio, Alexandre Angoulvant, Adela Albano, Laetitia Attias, Philippe Bellanger, Anne Pauline Bertrand, Dominique Bonhomme, Julie Botterel, Françoise Bouvier, Nicolas Buchler, Matthias Chouaki, Taieb Crépin, Thomas Durieux, Marie-Fleur Desoubeaux, Guillaume Doppelt, Gary Favennec, Loïc Fekkar, Arnaud Fourdinier, Ophélie Frimat, Marie Gangneux, Jean-Pierre Garandeau, Claire Hasseine, Lilia Hennequin, Christophe Iriart, Xavier Kamar, Nassim Kaminski, Hannah Kormann, Raphael Lachaud, Laurence Legendre, Christophe Le Quintrec Donnette, Moglie Leroy, Jordan Levi, Charlène Machouart, Marie Marx, David Menotti, Jean Moal, Valérie Morio, Florent Mrozek, Natacha Nicolas, Muriel Poirier, Philippe Peraldi, Marie-Noelle Poussot, Benjamin Ranque, Stéphane Rerolle, Jean-Philippe Sendid, Boualem Snanoudj, Renaud Tourret, Jérôme Vasse, Marc Vigneau, Cécile Villard, Odile Mesnard, Laurent Lanternier, Fanny Rafat, Cédric |
author_sort | Tardieu, Laurène |
collection | PubMed |
description | Cryptococcosis is the third most common cause of invasive fungal infection in solid organ transplant recipients and cryptococcal meningitis (CM) its main clinical presentation. CM outcomes, as well as its clinical features and radiological characteristics, have not yet been considered on a large scale in the context of kidney transplantation (KT). We performed a nationwide retrospective study of adult patients diagnosed with cryptococcosis after KT between 2002 and 2020 across 30 clinical centers in France. We sought to describe overall and graft survival based on whether KT patients with cryptococcosis developed CM or not. Clinical indicators of CNS involvement and brain radiological characteristics were assessed. Eighty-eight cases of cryptococcosis were diagnosed during the study period, with 61 (69.3%) cases of CM. Mortality was high (32.8%) at 12 months (M12) but not significantly different whether or not patients presented with CM. Baseline hyponatremia and at least one neurological symptom were independently associated with CM (p < 0.001). Positive serum cryptococcal antigen at diagnosis was also significantly associated with CM (p < 0.001). On magnetic resonance imaging (MRI), three patterns of brain injury were identified: parenchymal, meningeal, and vascular lesions. Although CM does not affect graft function directly, it entails a grim prognosis. |
format | Online Article Text |
id | pubmed-9227085 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-92270852022-06-25 Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France Tardieu, Laurène Divard, Gillian Lortholary, Olivier Scemla, Anne Rondeau, Éric Accoceberry, Isabelle Agbonon, Rémi Alanio, Alexandre Angoulvant, Adela Albano, Laetitia Attias, Philippe Bellanger, Anne Pauline Bertrand, Dominique Bonhomme, Julie Botterel, Françoise Bouvier, Nicolas Buchler, Matthias Chouaki, Taieb Crépin, Thomas Durieux, Marie-Fleur Desoubeaux, Guillaume Doppelt, Gary Favennec, Loïc Fekkar, Arnaud Fourdinier, Ophélie Frimat, Marie Gangneux, Jean-Pierre Garandeau, Claire Hasseine, Lilia Hennequin, Christophe Iriart, Xavier Kamar, Nassim Kaminski, Hannah Kormann, Raphael Lachaud, Laurence Legendre, Christophe Le Quintrec Donnette, Moglie Leroy, Jordan Levi, Charlène Machouart, Marie Marx, David Menotti, Jean Moal, Valérie Morio, Florent Mrozek, Natacha Nicolas, Muriel Poirier, Philippe Peraldi, Marie-Noelle Poussot, Benjamin Ranque, Stéphane Rerolle, Jean-Philippe Sendid, Boualem Snanoudj, Renaud Tourret, Jérôme Vasse, Marc Vigneau, Cécile Villard, Odile Mesnard, Laurent Lanternier, Fanny Rafat, Cédric Pathogens Article Cryptococcosis is the third most common cause of invasive fungal infection in solid organ transplant recipients and cryptococcal meningitis (CM) its main clinical presentation. CM outcomes, as well as its clinical features and radiological characteristics, have not yet been considered on a large scale in the context of kidney transplantation (KT). We performed a nationwide retrospective study of adult patients diagnosed with cryptococcosis after KT between 2002 and 2020 across 30 clinical centers in France. We sought to describe overall and graft survival based on whether KT patients with cryptococcosis developed CM or not. Clinical indicators of CNS involvement and brain radiological characteristics were assessed. Eighty-eight cases of cryptococcosis were diagnosed during the study period, with 61 (69.3%) cases of CM. Mortality was high (32.8%) at 12 months (M12) but not significantly different whether or not patients presented with CM. Baseline hyponatremia and at least one neurological symptom were independently associated with CM (p < 0.001). Positive serum cryptococcal antigen at diagnosis was also significantly associated with CM (p < 0.001). On magnetic resonance imaging (MRI), three patterns of brain injury were identified: parenchymal, meningeal, and vascular lesions. Although CM does not affect graft function directly, it entails a grim prognosis. MDPI 2022-06-17 /pmc/articles/PMC9227085/ /pubmed/35745553 http://dx.doi.org/10.3390/pathogens11060699 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Tardieu, Laurène Divard, Gillian Lortholary, Olivier Scemla, Anne Rondeau, Éric Accoceberry, Isabelle Agbonon, Rémi Alanio, Alexandre Angoulvant, Adela Albano, Laetitia Attias, Philippe Bellanger, Anne Pauline Bertrand, Dominique Bonhomme, Julie Botterel, Françoise Bouvier, Nicolas Buchler, Matthias Chouaki, Taieb Crépin, Thomas Durieux, Marie-Fleur Desoubeaux, Guillaume Doppelt, Gary Favennec, Loïc Fekkar, Arnaud Fourdinier, Ophélie Frimat, Marie Gangneux, Jean-Pierre Garandeau, Claire Hasseine, Lilia Hennequin, Christophe Iriart, Xavier Kamar, Nassim Kaminski, Hannah Kormann, Raphael Lachaud, Laurence Legendre, Christophe Le Quintrec Donnette, Moglie Leroy, Jordan Levi, Charlène Machouart, Marie Marx, David Menotti, Jean Moal, Valérie Morio, Florent Mrozek, Natacha Nicolas, Muriel Poirier, Philippe Peraldi, Marie-Noelle Poussot, Benjamin Ranque, Stéphane Rerolle, Jean-Philippe Sendid, Boualem Snanoudj, Renaud Tourret, Jérôme Vasse, Marc Vigneau, Cécile Villard, Odile Mesnard, Laurent Lanternier, Fanny Rafat, Cédric Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France |
title | Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France |
title_full | Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France |
title_fullStr | Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France |
title_full_unstemmed | Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France |
title_short | Cryptococcal Meningitis in Kidney Transplant Recipients: A Two-Decade Cohort Study in France |
title_sort | cryptococcal meningitis in kidney transplant recipients: a two-decade cohort study in france |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227085/ https://www.ncbi.nlm.nih.gov/pubmed/35745553 http://dx.doi.org/10.3390/pathogens11060699 |
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