Immune reconstitution syndrome after voriconazole treatment for cryptococcal meningitis in a liver transplant recipient

Liver Transpl. 2008 Nov;14(11):1671-4. doi: 10.1002/lt.21601.

Abstract

A new entity that comprises symptomatic worsening of an infectious or inflammatory process despite appropriate treatment was described a few years ago in human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy. This entity was defined as immune reconstitution syndrome, and it is believed to result from an intense inflammatory reaction in patients with an appropriately treated infection who recover immunological status. Recently, immune reconstitution syndrome has also been described in transplant recipients, although information is scarce because of its low incidence. Here we describe a new case of immune reconstitution syndrome in a liver transplant recipient after successful treatment of cryptococcal meningitis.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Retroviral Agents / therapeutic use
  • Antifungal Agents / adverse effects
  • Antifungal Agents / therapeutic use
  • Female
  • HIV Infections / drug therapy
  • Humans
  • Immune Reconstitution Inflammatory Syndrome / diagnosis
  • Immune Reconstitution Inflammatory Syndrome / etiology*
  • Immune Reconstitution Inflammatory Syndrome / therapy
  • Immune System
  • Inflammation
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / methods
  • Magnetic Resonance Imaging / methods
  • Meningitis, Cryptococcal / drug therapy*
  • Middle Aged
  • Pyrimidines / adverse effects
  • Pyrimidines / therapeutic use*
  • Recurrence
  • Triazoles / adverse effects
  • Triazoles / therapeutic use*
  • Voriconazole

Substances

  • Adrenal Cortex Hormones
  • Anti-Retroviral Agents
  • Antifungal Agents
  • Pyrimidines
  • Triazoles
  • Voriconazole