title: Cryptococcal pleuritis containing a high level of adenosine deaminase in a patient with AIDS: a case report.
abstract: Cryptococcal infection is the 4th most common opportunistic infection in patients with acquired immune deficiency syndrome (AIDS). Although pleural effusion alone is an unusual presentation, we present a case of cryptococcal pleuritis in an AIDS patient which was initially difficult to discriminate from tuberculous pleuritis because of the high level of pleural adenosine deaminase (ADA). Cryptococcus neoformans was detected in the culture of the pleural effusion after the initiation of antituberculous treatment. High levels of ADA in the pleural fluid can be observed in patients with cryptococcal pleuritis, and longer incubation of pleural fluid should be performed in all patients who present with pleuritis associated with a high ADA level as the only significant finding.
authors.affiliation: Department of Infectious Diseases, Graduate School of Medicine, University of Tokyo, Tokyo 113-8655, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yoshino
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kitazawa
authors.forename: Keita
authors.initials: K
authors.lastname: Tatsuno
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ota
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000201:enzymology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000243:Adenosine Deaminase / Q000378:metabolism*; D003453:Cryptococcosis / Q000175:diagnosis / Q000201:enzymology*; D003455:Cryptococcus neoformans / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010998:Pleurisy / Q000201:enzymology / Q000382:microbiology*
chemical_list: D000243:Adenosine Deaminase