{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:46:52Z","timestamp":1753879612719,"version":"3.41.2"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cryptococcal disease is a rare but often serious infection in solid organ transplant recipients, commonly presenting as meningitis and pneumonia but can rarely cause myositis. We report the case of a 43\u2010year\u2010old female kidney transplant recipient with two previous graft failures requiring re\u2010transplantations who presented with a 1\u2010month duration of worsening unilateral leg pain, swelling, and shortness of breath. Blood cultures isolated <jats:italic>Cryptococcus neoformans<\/jats:italic>. A calf biopsy was performed and histopathology revealed myonecrosis with yeast forms consistent with <jats:italic>Cryptococcus<\/jats:italic> spp. Liposomal amphotericin B (LamB) was administered. Her course was complicated by hypoxemic respiratory failure with development of ground glass opacities on chest imaging. Work\u2010up revealed bacterial and <jats:italic>C\u00a0neoformans<\/jats:italic> pneumonia and probable <jats:italic>Pneumocystis jirovecii<\/jats:italic> pneumonia (PJP) She received trimethoprim\u2010sulfamethoxazole and LamB and was discharged on fluconazole. Shortly thereafter she was re\u2010admitted with confusion, septic shock, and multi\u2010organ failure. Work\u2010up revealed PJP with subsequent development of cryptococcal meningitis. Despite aggressive management, she expired. Disseminated cryptococcal infection may manifest as myositis. Presence of cryptococcal infection is a marker of severe net state of immunosuppression (IS), hence, presence of other opportunistic infections is likely. Early recognition of cryptococcal infection, institution of targeted therapy, and IS reduction are important to improve overall survival.<\/jats:p>","DOI":"10.1111\/tid.13491","type":"journal-article","created":{"date-parts":[[2020,10,11]],"date-time":"2020-10-11T12:15:10Z","timestamp":1602418510000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Unilateral leg pain caused by cryptococcal myositis: An unusual presentation of disseminated cryptococcosis in a kidney transplant recipient"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7548-4140","authenticated-orcid":false,"given":"Audun J.","family":"Lier","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases Department of Internal Medicine Yale University School of Medicine New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarthak","family":"Virmani","sequence":"additional","affiliation":[{"name":"Section of Nephrology Department of Internal Medicine Yale University School of Medicine New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ysabel","family":"Ilagan\u2010Ying","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yale University School of Medicine New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nalin","family":"Leelatian","sequence":"additional","affiliation":[{"name":"Department of Pathology Yale University School of Medicine New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armine","family":"Darbinyan","sequence":"additional","affiliation":[{"name":"Department of Pathology Yale University School of Medicine New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5720-9994","authenticated-orcid":false,"given":"Maricar F.","family":"Malinis","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases Department of Internal Medicine Yale University School of Medicine New Haven CT 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Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13491","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.13491","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T05:14:00Z","timestamp":1693545240000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.13491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,27]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1111\/tid.13491"],"URL":"https:\/\/doi.org\/10.1111\/tid.13491","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"type":"print","value":"1398-2273"},{"type":"electronic","value":"1399-3062"}],"subject":[],"published":{"date-parts":[[2020,10,27]]},"assertion":[{"value":"2020-09-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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