Cure of disseminated cryptococcal infection in a renal allograft recipient after addition of gamma-interferon to anti-fungal therapy

Am J Transplant. 2005 Aug;5(8):2067-9. doi: 10.1111/j.1600-6143.2005.00947.x.

Abstract

The immunosuppressive regimens that are used in solid organ transplantation are potent inhibitors of Th0 as well as Th1 and Th2 cell-mediated immune responses. This predisposes patients to disseminated cryptococcal infections. Mortality in such patients remains very high despite advances in anti-fungal chemotherapy. We describe a case of disseminated cryptococcal disease in a renal allograft recipient that failed to respond to prolonged treatment with several anti-fungal drugs. However, addition of the immuno-modulator, interferon-gamma, resulted in the formation of granulomas and the resolution of his disease within 4-6 weeks. As we cannot find a similar example of combination therapy for disseminated cryptococcal disease in the solid organ transplant literature, we propose that interferon-gamma could be used in synergy with anti-fungal drugs to cure disseminated cryptococcal infections in solid organ transplant patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • Cryptococcosis* / microbiology
  • Cryptococcosis* / physiopathology
  • Drug Therapy, Combination
  • Humans
  • Interferon-gamma / therapeutic use*
  • Kidney Transplantation / adverse effects*
  • Male
  • Mycoses / physiopathology
  • Mycoses / virology
  • Transplantation, Homologous

Substances

  • Antifungal Agents
  • Antiviral Agents
  • Interferon-gamma