[A case of secondary pulmonary cryptococcosis with pleural effusion involving type 1 allergy].
A 69-year-old man who had been followed for pneumoconiosis complained of dyspnea with effort. He was hospitalized because chest roentogenography showed pleural effusion. Further examination of this pleural effusion revealed an eosinophilic cell population and with a varied appearance. First, we suspected tuberculous pleuritis from the characteristics of the pleural effusion, but we could not demonstrate the existence of any acid-fast bacilli. During diagnostic studies, the patient's respiratory status gradually worsened, making it impossible to obtain essential findings. We initiated steroid administration as an antidote to progressive respiratory failure, and carried out bronchoscopy; As a result, we diagnosed secondary pulmonary cryptococcosis from bronchoalveolar lavarge and transbronchial lung biopsy. Pulmonary cryptococcosis with pleural effusion is rare, and this may be the first report of a case involving a type 1 allergy. We speculate that immunological dysfunction contributed to disease progression in this case.
4th Department of Internal Medicine, Nippon Medical School.
Takahito
T
Nei
Tatsuji
T
Enomoto
Tetsu
T
Sakamoto
Akiko
A
Shingu
Shinji
S
Abe
Jiro
J
Usuki
Arata
A
Azuma
Shoji
S
Kudoh
Masashi
M
Kawamoto
D003453:Cryptococcosis / Q000209:etiology*; D018450:Disease Progression; D006801:Humans; D008172:Lung Diseases, Fungal / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000150:complications*; D011009:Pneumoconiosis / Q000150:complications*; D012130:Respiratory Hypersensitivity / Q000150:complications*