Meningeal cryptococcosis in a pancreas transplant recipient requiring grafectomy: A case report  

作　　者：Ileana Lulic Gorana Fingler Dinka Lulic Jadranka Pavicic Saric Danko Mikulic Tajana Filipec Kanizaj Eleonora Goluza 

机构地区：[1]Department of Anaesthesiology,Intensive Care and Pain Medicine,Clinical Hospital Merkur,Zagreb 10000,Croatia [2]Immediate Medical Care Unit,Saint James Hospital,Sliema SLM-1030,Malta [3]Department of Surgery,Clinical Hospital Merkur,Zagreb 10000,Croatia [4]Department of Gastroenterology,Clinical Hospital Merkur,Zagreb 10000,Croatia [5]Department of Anesthesiology,Intensive Care Medicine and Pain Therapy,University Hospital Center Zagreb,Zagreb 10000,Croatia

出　　处：《World Journal of Gastrointestinal Surgery》2024年第9期3032-3040,共9页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Through continuous improvement in transplantation medicine,a wider range of solid organ transplant(SOT)recipients is considered suitable for complex procedures.Despite advances in modern transplantation practice,transpiring invasive fungal infections pose a substantial threat for SOT recipients.To our knowledge,cryptococcal infection confined amidst sole pancreas SOT recipients has not been described to date.Enforcement of a multidisciplinary transplant team approach in the management of pancreas SOT recipients presenting with complex cryptococcal complications is fundamental in improving patient outcomes.CASE SUMMARY We present the case of a female pancreas transplant recipient,with confirmed meningeal cryptococcosis,referred to our institution for further evaluation and treatment from the Regional Center for Infectious Diseases.On admission,the patient was weaned from the protocolized immunosuppression therapy for two consecutive weeks,in addition to tapering systemic corticosteroid remedial treatment.Our novel multidisciplinary transplant team approach embodied exhaustive discussions of possible complex and diverse multiple organ system physiologic and pathologic challenges associated with distinct management strategies in pancreas transplant recipients.Owing to the potentially devastating impact of invasive cryptococcosis in terms of morbidity and mortality,a definitive surgical intervention of pancreas transplant grafectomy was reinforced,as a pathway towards secure access to early meaningful expertise care.The patient was discharged to the Regional Center for Infectious Diseases 2 mo after the admittance further advancing to a clinical improvement.CONCLUSION The precision transplantation approach by tailoring complex medical interventions to individual needs proved indispensable in improving our patient’s outcomes.

关 键 词：Solid organ transplantation Pancreas transplantation COMPLICATIONS Meningeal cryptococcosis MANAGEMENT Grafectomy Case report 

分 类 号：R735.9[医药卫生—肿瘤]