Cryptococcal Infection Presenting as a Pleural Effusion in a Liver Transplant Recipient

We report a rare case of a liver transplant recipient who experienced acute respiratory failure early posttransplantation because of cryptococcal pleural effusion. Although cryptococcal disease presenting solely as pleural effusion has been reported in the literature, it is not widely described in liver transplant recipients. Cryptococcal disease usually manifests late in the posttransplant period, whereas our patient was diagnosed with the infection early posttransplant. Diagnosis was made by pleural fluid culture. The initial serum cryptococcal antigen testing was negative. This case demonstrates the potential of subclinical or latent infections in patients with cirrhosis and liver transplant recipients and the importance of considering pleural fluid culture in the diagnostic evaluation of pleural effusions in cirrhotic patients.