Disseminated cryptococcal infection with eosinophilia in a healthy person.
A 23-year-old man with no recent medical history was hospitalized complaining of high fever and cough. In addition to very marked eosinophilia, chest X-ray revealed extensive bronchovascular bundle thickening. Transbronchial lung biopsy (TBLB) showed moderate eosinophil infiltration. Cryptococcus neoformans infection was diagnosed, based on blood culture, cerebrospinal fluid culture, urine culture, and lung biopsy specimens. The eosinophilia was successfully alleviated by treatment for cryptococcal meningitis. Furthermore, cryptococcal sepsis resolved with amphotericin B and 5-flucytosine treatment. Eosinophilia commonly occurs following chronic Aspergillus infection, but the present case suggests the involvement of Cryptococcus in another mechanism for eosinophilia.
Yamaguchi
Hiromichi
H
Department of Respiratory Internal Medicine, St. Marianna University School of Medicine, Yokohama-city Seibu Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama 241-0811, Japan. yamaguchi-h@mug.biglobe.ne.jp
Komase
Yuko
Y
Ikehara
Mizuki
M
Yamamoto
Takahito
T
Shinagawa
Toshihito
T
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003453:Cryptococcosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D004359:Drug Therapy, Combination; D004802:Eosinophilia / Q000382:microbiology*; D005437:Flucytosine / Q000627:therapeutic use; D006801:Humans; D008172:Lung Diseases, Fungal / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008198:Lymph Nodes / Q000382:microbiology*; D008297:Male; D011859:Radiography
D000935:Antifungal Agents; D000666:Amphotericin B; D005437:Flucytosine