{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T08:35:48Z","timestamp":1717490148927},"reference-count":12,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,4,21]],"date-time":"2014-04-21T00:00:00Z","timestamp":1398038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Disseminated <jats:italic><jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ryptococcus<\/jats:italic> disease occurs in patients with defective T\u2010cell immunity. Cryptococcal meningitis following autologous stem cell transplant (<jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>) has been described previously in only 1 patient, 4\u00a0months post <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> and while off antifungal prophylaxis. We present a unique case of <jats:italic><jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ryptococcus<\/jats:italic> meningitis pre\u2010engraftment after autologous <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>, while the patient was receiving fluconazole prophylaxis. A 41\u2010year\u2010old man with non\u2010<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>odgkin's lymphoma underwent autologous <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>. Post\u2010transplant prophylaxis consisted of fluconazole 400\u00a0mg daily, levofloxacin 500\u00a0mg daily, and acyclovir 800\u00a0mg twice daily. On day 9 post transplant, he developed fever and headache. Peripheral white blood cell count (<jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content>) was 700\/\u03bcL. Magnetic resonance imaging of the brain showed lesions consistent with meningoencephalitis. Cerebrospinal fluid (<jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content>) analysis revealed a <jats:styled-content style=\"fixed-case\">WBC<\/jats:styled-content> of 39 with 77% lymphocytes, protein 63, glucose 38, <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> pressure 20.5\u00a0cm<jats:styled-content style=\"fixed-case\"><jats:roman>H<jats:sub>2<\/jats:sub>O<\/jats:roman><\/jats:styled-content>, and a positive cryptococcal antigen. <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> culture confirmed <jats:italic><jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ryptococcus neoformans<\/jats:italic>. The patient was treated with liposomal amphotericin B 5\u00a0mg\/kg intravenously daily, and flucytosine 37.5\u00a0mg\/kg orally every 6\u00a0h. He was switched to fluconazole 400\u00a0mg daily after 3\u00a0weeks of amphotericin therapy, with sterilization of the <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> with negative <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content><jats:italic><jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ryptococcus<\/jats:italic> antigen and negative <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> culture. Review of the literature revealed 9 cases of cryptococcal disease in recipients of <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>. Median time of onset was 64\u00a0days post transplant. Only 3 meningitis cases were described; 2 of them after allogeneic <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content>. Fungal prophylaxis with fluconazole post autologous <jats:styled-content style=\"fixed-case\">SCT<\/jats:styled-content> is recommended at least through engraftment, and for up to 100\u00a0days in high\u2010risk patients. A high index of suspicion is needed to diagnose and treat opportunistic infections, especially in the face of immunosuppression and despite adequate prophylaxis. Infection is usually fatal without treatment, thus prompt diagnosis and therapy might be life saving.<\/jats:p>","DOI":"10.1111\/tid.12216","type":"journal-article","created":{"date-parts":[[2014,4,21]],"date-time":"2014-04-21T08:15:30Z","timestamp":1398068130000},"page":"473-476","source":"Crossref","is-referenced-by-count":8,"title":["Cryptococcal meningitis post autologous stem cell transplantation"],"prefix":"10.1111","volume":"16","author":[{"given":"S.","family":"Chaaban","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University of Kansas School of Medicine\u2010Wichita Wichita Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.J.","family":"Wheat","sequence":"additional","affiliation":[{"name":"MiraVista Diagnostics Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Assi","sequence":"additional","affiliation":[{"name":"Infectious Disease Department of Internal Medicine University of Kansas School of Medicine\u2010Wichita Wichita Kansas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,4,21]]},"reference":[{"issue":"10","key":"e_1_2_5_2_1","first-page":"694","article-title":"Use of fluconazole in the treatment of non\u2010AIDS cryptococcal meningitis","volume":"89","author":"Antony SJ","year":"1997","journal-title":"J Natl Med Assoc"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2011.52.3.482"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.48.9.853"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/313546"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3282a4a64d"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.3855\/jidc.725"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-011-9423-9"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/93.4.245"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/598936"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1703646"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.1.481-483.2004"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/08880019709028778"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftid.12216","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.12216","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T15:24:19Z","timestamp":1695569059000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.12216"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,21]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014,6]]}},"alternative-id":["10.1111\/tid.12216"],"URL":"https:\/\/doi.org\/10.1111\/tid.12216","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,21]]}}}