title: [Clinical problems in medical mycology: problem number 46].
abstract: A 49 year old-man, without known previous diseases, who suffered an acute lung infection, is presented. He was a smoker and belonged to a high socioeconomic class. He suddenly presented high fever, dry cough and legs' pain. Thorax X-ray and CT scan showed two excavated pneumonic infiltrates in the lower part of the right lung. He was treated with antibacterial antibiotics without clinical response. A transparietal fine needle lung biopsy was performed and the histopathology and cytological studies revealed an epithelioid granuloma with capsulated yeasts. Cryptococcus neoformans antigenemia was positive 1/128, and brain MR, as well as CSF studies, allowed to rule out a central nervous system compromise. The patient was successfully treated with itraconazole by oral route at a daily dose of 400mg during 6 months. Post-treatment thorax CT scan showed a thin walled lung cavity as a sequela.
authors: Centro de Estudios Micológicos, Buenos Aires, Argentina. Electronic address: ricardonegroni@intramed.net.
authors: Ricardo
authors: R
authors: Negroni
authors: Centro de Estudios Micológicos, Buenos Aires, Argentina.
authors: Alicia
authors: A
authors: Arechavala
authors: Centro de Estudios Micológicos, Buenos Aires, Argentina.
authors: Gabriela
authors: G
authors: Santiso
authors: Centro de Estudios Micológicos, Buenos Aires, Argentina.
authors: Pablo
authors: P
authors: Bonvehí
mesh_terms: D003453:Cryptococcosis / Q000175:diagnosis*; D003455:Cryptococcus neoformans; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged