[A case of pulmonary cryptococcosis with multiple nodular shadows under treatment of bronchiolitis obliterans with organizing pneumonia (BOOP)].
A 66 year-old man was introduced to our hospital because of multiple infiltrative pulmonary shadows on February, 2001. We diagnosed bronchiolitis obliterans with organizing pneumonia (BOOP) from the clinical and bronchoalveolar lavage fluid (BALF) findings, and initiated oral steroid therapy. Since the abnormal chest shadows disappeared, the dose of steroid was decreased and maintained at 10 mg/day. In August 2001, multiple infiltrative shadows returned, and we therefore increased the steroid dose to 30 mg/day. The expanding infiltrative shadows were then joined by new multiple nodular shadows. The bronchioalveolar lavage fluid revealed small bodies of cryptococcus species. A positive result for anti-cryptococcus antigen was also obtained from the serum. We then diagnosed pulmonary cryptococcosis without meningitis. Therapy was started with anti-mycotic agents including amphotericin-B, flucytosine and fluconazole, which proved successful. This case of opportunistic cryptococcus infection in an immunocompromized patient, which responded to anti-mycotic therapy, is reported.
Tashiro
Naohiko
N
Department of Respiratory Medicine, National Dohoku Hospital 4048, 7 Hanasakicho, Asahikawa 070-8644, Japan.
Takahashi
Masaaki
M
Sato
Kazue
K
Yamamoto
Yasushi
Y
Takeda
Akinori
A
Nishigaki
Yutaka
Y
Fujiuchi
Satoru
S
Okamoto
Kiyotaka
K
Yamasaki
Yasuhiro
Y
Fujita
Yuka
Y
Fujikane
Toshiaki
T
Shimizu
Tetsuo
T
D000368:Aged; D003453:Cryptococcosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D018549:Cryptogenic Organizing Pneumonia / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage; D020551:Pulse Therapy, Drug; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
D011239:Prednisolone