Clinical characteristics on 11 immunocompetent patients with pulmonary cryptococcosis and literature review

Abstract

Abstract:

Objective To investigate the clinical characteristics of PC in 11 immunocompetent patients. Methods Eleven PC cases diagnosed histopathologically and mycologically from January 2004 to December 2016 were investigated retrospectively. General clinical data, radiology, way of diagnosis were analyzed. Results Eleven patients were immunocompetent. Seven PC patients (63.6%) had obesity, hypertension or coronary heart disease; one patient had smoking history for 20 years; only one case was found during checkup. Six cases were misdiagosised (54.54%,6/11), carcinoma of lung was the most misdiagnosised disease. The most common CT finding in those patients with pulmonary cryptococcosis was pulmonary solitary nodules with halo sign in middle and lowerlung predominance. Areas of hazy increased attenuation, and areas of cavitation were uncommon. Nine of 11 PC patients were diagnosised by histopathological examination; 2 of them found the Cryptococcus spp. in ink KOH test; one had positive serum cryptococcal antigen (CrAg). Conclusion PC could occurred in immunocompetent individuals with obesity, hypertension or coronary heart disease. Smoking could also be a risk factor. CT commonly demonstrated pulmonary solitary nodules in middle and upper lung. Definitive diagnosis could be made histopathologically. Better diagnostic outcomes could be achieved by bronchoscopy, bronchoalveolar lavage/trans-bronchial biopsy, or via thoracotomy-directed biopsy.

Key words: immunocompetent, pulmonary, cryptococcosis, radiology

CLC Number:

R519.4

WANG Yan-ling, YANG Yu-heng, YU Nong, DENG Shu-wen. Clinical characteristics on 11 immunocompetent patients with pulmonary cryptococcosis and literature review[J]. Chinese Journal of Mycology, 2018, 13(3): 148-151,163.

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