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

World Journal of Gastrointestinal Surgery 2024年第9期16卷 3032-3040页

作者： Ileana Lulic Gorana Fingler Dinka Lulic Jadranka Pavicic Saric Danko Mikulic Tajana Filipec Kanizaj Eleonora Goluza Department of Anaesthesiology Intensive Care and Pain MedicineClinical Hospital MerkurZagreb 10000Croatia Immediate Medical Care Unit Saint James HospitalSliema SLM-1030Malta Department of Surgery Clinical Hospital MerkurZagreb 10000Croatia Department of Gastroenterology Clinical Hospital MerkurZagreb 10000Croatia Department of Anesthesiology Intensive Care Medicine and Pain TherapyUniversity Hospital Center ZagrebZagreb 10000Croatia

BACKGROUND Through continuous improvement in transplantation medicine,a wider range of solid organ transplant(SOT)recipients is considered suitable for complex *** advances in modern transplantation practice,transpiring invasive fungal infections pose a substantial threat for SOT *** our knowledge,cryptococcal infection confined amidst sole pancreas SOT recipients has not been described to *** of a multidisciplinary transplant team approach in the management of pancreas SOT recipients presenting with complex cryptococcal complications is fundamental in improving patient *** 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 *** admission,the patient was weaned from the protocolized immunosuppression therapy for two consecutive weeks,in addition to tapering systemic corticosteroid remedial *** 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 *** 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 *** patient was discharged to the Regional Center for Infectious Diseases 2 mo after the admittance further advancing to a clinical *** 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

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