[Primary pulmonary cryptococcosis: a case series of 9 patients].
We retrospectively reviewed 9 consecutive cases of primary pulmonary cryptococcosis having no comorbidity. At diagnosis, seven had no subjective symptoms and two had subtle symptom. Chest CT scan showed nodular shadows in 8, while 3 cases had infiltrative shadows. Eight of the nine were diagnosed with histopathology obtained by transbronchial lung biopsy or CT-guided needle aspiration biopsy. We also assessed PHA and Con A lymphocyte stimulation tests to measure cellular immune function in 6, four of whom showed decreased reaction of lymphocytes. We successfully treated seven of the nine with fluconazole alone and used fluconazole as a maintenance regimen in two. No relapse or treatment failure was seen after completion of antifungal treatment. Six cases were seropositive for serum cryptococcus antigen titer at diagnosis and only one showed seroconversion. We concluded that the duration of therapy for primary pulmonary cryptococcosis should not be necessarily determined by serum cryptococcus antigen seroconversion.
Sakamoto
Koji
K
Division of respiratory medicine and allergy, Tosei General Hospital.
Aso
Hiromichi
H
Yokoyama
Toshiki
T
Kato
Keisuke
K
Nishiyama
Osamu
O
Kimura
Tomoki
T
Kondoh
Yasuhiro
Y
Taniguchi
Hiroyuki
H
D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use*; D003453:Cryptococcosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D015725:Fluconazole