title: [Pulmonary cryptococcosis combined with pulmonary tuberculosis].
abstract: We report a rare combination of pulmonary cryptococcosis and pulmonary tuberculosis in a diabetic patient. A 63-year-old man was admitted to our hospital in January 2002 for evaluation of an abnormal chest radiograph. In 1999, the abnormality had first been detected by mass screening radiography. In 2000, an abnormality in a chest radiograph was again detected in a mass screening, and he visited another hospital. A chest CT scan revealed a cavitating lesion and several nodules in the left lower lobe. Fiberoptic bronchoscopy was performed, but was not diagnostic. The patient was referred to our hospital. He had a history of diabetes mellitus starting in 1984. The chest CT scan revealed solid nodules in the left lower lobe and several micronodules in both upper lobes. Video-assisted thoracoscopic surgery was performed and specimens were obtained from the left S8 and left S1 + 2. Histologically, cryptococci were detected in the resected left S8. In addition, mycobacterium tuberculosis was cultured from the resected left S1 + 2. A diagnosis of combined pulmonary cryptococcal and tuberculous infections was made and treatment with itraconazole, isoniazid sodium methansulfonate, rifampicin, and ethambutol hydrochloride was given.
authors.affiliation: Division of Respiratory Diseases, Toranomon Hospital.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Kishi
authors.forename: Sakae
authors.initials: S
authors.lastname: Homma
authors.forename: Atsuko
authors.initials: A
authors.lastname: Kurosaki
authors.forename: Masateru
authors.initials: M
authors.lastname: Kawabata
authors.forename: Eiyasu
authors.initials: E
authors.lastname: Tsuboi
authors.forename: Koji
authors.initials: K
authors.lastname: Narui
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Nakatani
authors.forename: Tadasu
authors.initials: T
authors.lastname: Kono
authors.forename: Noriko
authors.initials: N
authors.lastname: Motoi
authors.forename: Hiroichi
authors.initials: H
authors.lastname: Tanimoto
authors.forename: Koichiro
authors.initials: K
authors.lastname: Nakata
mesh_terms: D003453:Cryptococcosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D048909:Diabetes Complications; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D017964:Itraconazole / Q000627:therapeutic use; D008172:Lung Diseases, Fungal / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012293:Rifampin / Q000627:therapeutic use; D020775:Thoracic Surgery, Video-Assisted; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D017964:Itraconazole; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin