the Cryptococcal Collaborative Transplant Study Groupa

Background. We describe an immune reconstitution syndrome (IRS)–like entity in the course of evolution of Cryptococcus neoformans infection in organ transplant recipients. Methods. The study population comprised a cohort of 83 consecutive organ transplant recipients with cryp-tococcosis who were observed for a median of 2 years in an international, multicenter study. Results. In 4 (4.8%) of the 83 patients, an IRS-like entity was observed a median of 5.5 weeks after the initiation of appropriate antifungal therapy. Worsening of clinical manifestations was documented, despite cultures being negative for C. neoformans. These patients were significantly more likely to have received tacrolimus, my-cophenolate mofetil, and prednisone as the regimen of immunosuppressive therapy than were all other patient