关键词: 肺隐球菌病, 临床特点, 免疫状态, 影像学

Abstract: Objective To improve clinical diagnosis and treatment of pulmonary cryptococcosis by analyzing clinical characteristics of pulmonary cryptococcosis in patients with different immunological status.Methods We retrospectively analyzed the medical records of 100 patients diagnosed with pulmonary cryptococcosis in major teaching hospitals of Shanghai between 1998 and 2009.Results 46.00 % of the patients with pulmonary cryptococcosis had no other diseases previously. In clinic, the major primary symptoms included cough, expectoration, and fever. The patients without immune dysfunction usually had no symptoms, in which the lesions were mainly under pleurapulmonalis (66.22%), in unilateral lung (72.97%) and single lung lobe (59.46%), and mostly appeared as nodules or masses (55.41%). However, the lesions in patients with immune dysfunction varied with wide and random distribution. 14 out of 19 cases (73.68%) were diagnosed by the transbronchial lung biopsy (TBLB). 26 out of 36 cases (72.22%) were diagnosed by the percutancous cutting needle biopsy (PCNB).Conclusion The patients without other diseases previously cannot be excluded from pulmonary cryptococcosis. The lesions in patients without immune dysfunction are mainly under plierapulmonalis with limited distribution, and most of them appeare as nodules and masses. However, the lesions in patients with immune dysfunction vary with wide and random distribution.TBLB and PCNB are good methods for the diagnosis of pulmonary cryptococcosis with high positive rate, and they can also compensate each other.

Key words: pulmonary cryptococcosis, clinical characteristics, immune status, radiology