[Disseminated pulmonary infection due to Cryptococcus neoformans in a non immunocompromised patient].
We report a case of a primary pulmonary infection due to Cryptococcus neoformans developed in a 40 Year old immunocompetent and HIV negative man. Radiologic findings consisted in diffuse, bilateral reticular and nodular opacities. Bronchoscopy was normal and bronchoalveolar lavage showed numerous macrophages without associated pathogens. A thoracovideoscopy with an open lung biopsy showed numerous cryptococci, free in the alveoli or located within the macrophages. They were associated with an inflammatory infiltrate in the interalveolar spaces, predominantly composed of mononuclear cells. Ultrastructural study showed yeasts with numerous intracytoplasmic organites, a nucleus, a wall and a thick capsule. Pulmonary cryptococcosis is rare in immunocompetent hosts and can be difficult to diagnose since clinicoradiologic features observed in this cryptococcal infection mimic other infectious or neoplastic diseases.
Hofman
Véronique
V
Laboratoire de Pathologie Clinique et Expérimentale, Hôpital Pasteur, Nice. hofman@unice.fr
Venissac
Nicolas
N
Mouroux
Christine
C
Butori
Catherine
C
Mouroux
Jérôme
J
Hofman
Paul
P
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D003453:Cryptococcosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D003455:Cryptococcus neoformans / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D006801:Humans; D007121:Immunocompetence; D008168:Lung / Q000382:microbiology / Q000473:pathology* / Q000648:ultrastructure; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D011859:Radiography; D016896:Treatment Outcome
D000935:Antifungal Agents; D000666:Amphotericin B