title: Retrospective analysis of 76 immunocompetent patients with primary pulmonary cryptococcosis.
abstract: BACKGROUND
  Pulmonary cryptococcosis typically occurs in immunocompromised patients, but it can also occur in immunocompetent patients. Our objective was to describe the clinical manifestations, diagnosis, and management of primary pulmonary cryptococcosis in immunocompetent patients.
  
  
  METHODS
  We retrospectively reviewed the clinical data of 76 patients with primary pulmonary cryptococcosis who were admitted to our hospital from 1995 to 2010.
  
  
  RESULTS
  Pulmonary cryptococcosis was pathologically proven in all patients. Mean patient age was 42.5 years and 55 patients (72%) were male. The major clinical manifestations were cough (47 pts, 62%), expectoration (29 pts, 38%), fever (16 pts, 21%), chest pain (15 pts, 20%), dyspnea (17 pts, 22%), and emaciation (10 pts, 13%). Eighteen patients (24%) were asymptomatic. Most patients were admitted due to shadows on chest X-rays. Lesions were more common in the lower lung (60 pts, 78.9%) than in the upper lung (25 pts, 32.9%). More lesions (28 pts, 37%) were characterized by patchy consolidations. Pulmonary cryptococcosis was confirmed histologically among all patients. Surgical removal of lesions or treatment with fluconazole and other antifungal agents for complete courses led to favorable outcomes for most patients.
  
  
  CONCLUSIONS
  Primary pulmonary cryptococcosis was found mainly in immunocompetent patients aged <50 years without preexisting lung disease. Shadow on the chest X-ray is the predominant feature. Treatment with a complete course of fluconazole and/or other antifungal agents can achieve favorable outcome.
authors.affiliation: Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, Guangzhou Medical University, 151 Yan Jiang Road, Guangzhou, People's Republic of China. fye111@126.com
authors.forename: Feng
authors.initials: F
authors.lastname: Ye
authors.forename: Jia-xing
authors.initials: JX
authors.lastname: Xie
authors.forename: Qing-si
authors.initials: QS
authors.lastname: Zeng
authors.forename: Guo-qin
authors.initials: GQ
authors.lastname: Chen
authors.forename: Shu-qing
authors.initials: SQ
authors.lastname: Zhong
authors.forename: Nan-shan
authors.initials: NS
authors.lastname: Zhong
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002637:Chest Pain / Q000209:etiology; D003371:Cough / Q000209:etiology; D003453:Cryptococcosis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D003455:Cryptococcus neoformans; D004417:Dyspnea / Q000209:etiology; D004614:Emaciation / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007121:Immunocompetence; D008168:Lung / Q000601:surgery; D008172:Lung Diseases, Fungal / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents