Cavitating cryptococcal pneumonia in the immunocompetent host.
BACKGROUND
Isolated cryptococcal pneumonia in the immunocompetent host is a rare infection. Indications for treatment and its duration are currently not defined.


METHODS
Three patients presented with cavitating cryptococcal pneumonia.


METHODS
They were treated with oral fluconazole.


RESULTS
Improvement was evident clinically, radiologically and serologically. Fluconazole was continued until serum cryptococcal antigen (SCA) levels were negative in our patients as they had manifestations such as haemoptysis, cavitating or multi-lobar pneumonia and relatively high antigen levels, suggesting potentially serious disease.


CONCLUSIONS
Fluconazole is effective and safe for the treatment of cryptococcal pneumonia in the immunocompetent host. Although the role of monitoring SCA levels in the immunocompetent host is currently unclear, it may be an indication of infective burden and the benefits of longer treatment seem to outweigh the risks.
Koh
M S
MS
Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Outram Road, Singapore 169608.
Tan
B H
BH
Kurup
A
A
Hsu
A A L
AA
Eng
P
P
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D003453:Cryptococcosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D011859:Radiography
D000935:Antifungal Agents; D015725:Fluconazole