Cryptococcal pneumonia in African miners at autopsy.
METHODS
Deceased miners from South Africa whose cardiorespiratory organs were submitted for autopsy for compensation for occupational lung diseases from 1996 to 2000.


OBJECTIVE
To 1) calculate the prevalence of cryptococcal pneumonia in 8421 autopsied miners, a population with a high prevalence of human immunodeficiency virus (HIV) infection; 2) document the association of cryptococcal pneumonia with other pulmonary infection; 3) document the association of cryptococcal pneumonia with a clinical diagnosis of cryptococcal meningitis; and 4) determine the accuracy of the clinical diagnosis of cryptococcal pneumonia.


METHODS
Case series of 589 black miners with histological evidence of cryptococcal pneumonia at autopsy, defined as the presence of cryptococcal organisms in the lung parenchyma, identified by staining of the mucinous capsule.


RESULTS
The incidence of cryptococcal pneumonia at autopsy was 7%. Ninety-seven of the 589 cases (16.5%) had a concomitant respiratory infection, most commonly Pneumocystis jirovecii pneumonia (51.5%), followed by mycobacterial infection (42.3%). In life, cryptococcal meningitis was diagnosed in 46.9% and cryptococcal pneumonia in only 2.7%.


CONCLUSIONS
Although tuberculosis remains the most common HIV-associated respiratory disease in Africa, it is important to consider the diagnosis of cryptococcal pneumonia in acquired immune-deficiency syndrome (AIDS) patients, and to bear in mind the possibility of dual pathology.
Wong
M L
ML
Respiratory Unit, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.
Back
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Candy
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Nelson
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Murray
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D044383:Black People / Q000706:statistics & numerical data*; D003453:Cryptococcosis / Q000150:complications / Q000208:ethnology*; D015658:HIV Infections / Q000150:complications; D006801:Humans; D008172:Lung Diseases, Fungal / Q000150:complications / Q000208:ethnology*; D016919:Meningitis, Cryptococcal / Q000150:complications; D008875:Middle Aged; D008906:Mining; D011014:Pneumonia / Q000208:ethnology* / Q000382:microbiology; D015995:Prevalence; D013019:South Africa / Q000453:epidemiology