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

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 immunomodulator, interferon-γ, 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-γ could be used in synergy with antifungal drugs to cure disseminated cryptococcal infections in solid organ transplant patients. Copyright © Blackwell Munksgaard 2005.