Watson A J, Russell R P, Cabreja R F, Braverman R, Whelton A
Q J Med. 1985 May;55(217):169-72.
Cryptococcus neoformans is a significant pathogen in immunosuppressed patients. In renal transplant recipients receiving prednisone, the development of cryptococcosis is associated with a poor prognosis. When such patients develop cryptococcosis they pose a particularly difficult clinical dilemma since withdrawal of prednisone, to facilitate cure of their fungal infection, may predispose to loss of their transplanted kidney. We report our experience with cryptococcal infection in 13 renal transplant patients. In 11 of these patients maintenance immunosuppression was cautiously continued to preserve allograft function. The results of our study suggest that maintenance immunosuppressive therapy may be continued throughout the period of antifungal therapy and does not preclude eradication of the infecting organisms. Our experience indicates that the prognosis for the renal transplant patient who has cryptococcosis can be improved.
新型隐球菌是免疫抑制患者的重要病原体。在接受泼尼松治疗的肾移植受者中，隐球菌病的发生与预后不良相关。当这类患者发生隐球菌病时，会带来特别棘手的临床困境，因为停用泼尼松以促进真菌感染的治愈，可能会导致移植肾丧失。我们报告了13例肾移植患者隐球菌感染的经验。在其中11例患者中，谨慎地继续维持免疫抑制以保留移植肾功能。我们的研究结果表明，在抗真菌治疗期间可继续维持免疫抑制治疗，且这并不妨碍根除感染病原体。我们的经验表明，患有隐球菌病的肾移植患者的预后可以得到改善。
