Pulmonary cryptococcosis in non-AIDS patients.
OBJECTIVE
To clarify the clinical features and imaging characteristics of non-AIDS patients with pulmonary cryptococcosis.


METHODS
We retrospectively collected 15 HIV-negative patients with pathology-proved pulmonary cryptococcosis from Sep 1992 to Jan 2008. Their medical records and radiological data were reviewed and analyzed.


RESULTS
Only one patient was asymptomatic.Thirteen patients were immunocompetent and two were immunosuppressed. Three patients had associated cryptococcosis meningitis. The most common radiographic abnormalities were multiple pulmonary nodules or masses, seen in 8 and 5 cases of patients respectively. 14 patients received specific therapy for Cryptococcus neoformans. Two patients died. In the 11 patients with isolated pulmonary cryptococcosis, treatment consisted of fluconazole alone (n=7), in combination with amphotericin B (n=2), and both 5-flucytosine and amphotericin B (n=2). For the other 2 patients with cryptococcosis meningitis, one was treated with amphotericin B alone and the other with fluconazole combined with amphotericin B and 5-flucytosine.


CONCLUSIONS
Non-AIDS patients might also susceptible to cryptococcosis infection. Histological examination is the principal method of diagnosis. The most common CT findings are solitary or multiple nodules with or without cavitation in the subpleural areas of the lung.
Wu
Benquan
B
Department of Internal Medicine, Division of Pulmonary and Critical Care, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. zswbq@163.com
Liu
Hui
H
Huang
Jing
J
Zhang
Wenxian
W
Zhang
Tiantuo
T
D000293:Adolescent; D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003453:Cryptococcosis / Q000175:diagnosis* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use; D005437:Flucytosine / Q000008:administration & dosage / Q000627:therapeutic use; D018023:HIV Seronegativity; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole; D005437:Flucytosine