Cryptococcosis in patients with hematologic malignancies. A report from GIMEMA-infection program

Livio Pagano, Luana Fianchi, Cecilia Caramatti, Domenico D'Antonio, Lorella Melillo, Morena Caira, Luciano Masini, Giuseppe Todeschini, Corrado Girmenia, Bruno Martino, Saverio Cinieri, Pietro Martino, Albano Del Favero

Research output: Contribution to journalArticlepeer-review


Background and Objectives. Cryptococcosis is an important cause of morbidity and death in immunocompromised patients. The aim of this study was to evaluate clinical and laboratory characteristics, and outcome of patients with cryptococcosis complicating hematologic diseases. Design and Methods. This was a retrospective study, conducted over a ten-year period (1993-2002) in 21 hematology divisions, in tertiary care or university hospitals. Results. This study evaluated 17 patients with hematologic diseases who developed cryptococcosis. Possible risk factors recognized before the onset of the infection were: administration of steroids for the underlying malignancy (6 patients), diabetes mellitus (4 patients), cutaneous lesions (2 patients) and autoimmune disease, hepatic cirrhosis, chronic renal failure and exposure to pigeons (1 patient each). Five patients received prophylaxis, consisting of fluconazole in 2 cases. Fever, neurological and respiratory signs developed according to the primary sites of infection (5 blood, 5 central nervous system, 4 lung, and 1 each in gut, skin and mouth). Diagnosis was made by positive microbiological culture, antigen detection in serum or cerebrospinal fluid, or polymerase chain reaction. All patients started specific treatment (fluconazole, 7 patients; amphotericin-B deoxycolate or liposomal amphotericin-B, 10 patients). Two patients died from cryptococcosis within 30 days after diagnosis. Interpretation and Conclusions. Cryptococcosis in patients with hematologic malignancies is a rare complication. In neutropenic patients, it is less fatal than other fungal infections (i.e. aspergillosis or candidemia). Specific treatment, started promptly, positively influences the outcome.

Original languageEnglish
Pages (from-to)852-856
Number of pages5
Issue number7
Publication statusPublished - Jul 2004


  • Cryptococcus spp.
  • Hematologic malignancies

ASJC Scopus subject areas

  • Hematology


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