title: [A case of pulmonary cryptococcosis with multiple nodular shadows under treatment of bronchiolitis obliterans with organizing pneumonia (BOOP)].
abstract: 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.
authors.affiliation: Department of Respiratory Medicine, National Dohoku Hospital 4048, 7 Hanasakicho, Asahikawa 070-8644, Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Tashiro
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Kazue
authors.initials: K
authors.lastname: Sato
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Akinori
authors.initials: A
authors.lastname: Takeda
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nishigaki
authors.forename: Satoru
authors.initials: S
authors.lastname: Fujiuchi
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Okamoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yamasaki
authors.forename: Yuka
authors.initials: Y
authors.lastname: Fujita
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Fujikane
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shimizu
mesh_terms: 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
chemical_list: D011239:Prednisolone