A Case of "Cryptammonia": Disseminated Cryptococcal Infection Generating Profound Hyperammonemia in a Liver Transplant Recipient. (October 2022)

• Record Type: Journal Article
• Authors: Phillips, Steven M.; Pouch, Stephanie M.; Lo, Denise J.; Kandiah, Sheetal; Lomashvili, Koba A.; Subramanian, Ram A.; Moran, Peter; Killian, Alley; Kandiah, Prem A.
• Is Part Of: Journal of investigative medicine high impact case reports. Volume 10(2022)
• Publication Date: 2022-10
• Subjects: hyperammonemia -- liver transplant -- cryptococcus -- immunocompromised; Internal medicine -- Periodicals; Medical care -- Periodicals; 616.005
• DOI: 10.1177/23247096221129467
• Languages: English
• ISSNs: 2324-7096

Abstract

Mycoplasma and Ureaplasma infections have been described as a cause of hyperammonemia syndrome leading to devastating neurological injury in the post-transplant period, most commonly in lung transplant recipients. The occurrence of significant hyperammonemia caused by other urease-producing organisms remains unclear. We describe a case of disseminated cryptococcosis presenting with profound hyperammonemia in a 55-year-old orthotopic liver transplant recipient. Through a process of elimination, other potential causes for hyperammonemia were excluded revealing a probable association between hyperammonemia and disseminated cryptococcosis.