title: [Cryptococcal infection and sarcoidosis: a coincidence?].
abstract: BACKGROUND
  We report a case of cryptococcal infection that underwent in a patient with a medical history of asymptomatic sarcoidosis. This finding seems to be not incidental.
  
  
  METHODS
  A 35-years-old female was referred to hospital for a community-acquired pneumonia with pleural involvement. A physical examination showed a pleural syndrome. Chest imaging showed a parenchymal involvement with pleural effusion and numerous mediastinal nodes. Fiberoptic bronchoscopy revealed an obstruction of the right apical bronchus of the lower lobe. Biopsies and bronchoalveolar lavage confirmed a cryptococcal infection. The disease was considered as disseminated with a urinary and neurologic involvement. The outcome was fair under prolonged antifungal therapy.
  
  
  CONCLUSIONS
  Cryptococcal infection is generally associated with immunosuppression. We suggest that sarcoidosis, although non symptomatic, may be a condition that promote the onset of cryptococcal infection. Even rare, cryptococcal infection is the most frequent opportunistic infection recorded with sarcoidosis patients. Histologic similarities between sarcoidosis and cryptococcal infection and the role of the macrophages which phagocyte the Cryptococcus neoformans are one of the hypothesis to assess these pathologic findings. A register is warranted to recover all opportunistic infection related to sarcoidosis in order to better understand the pathogeny.
authors.affiliation: Service des maladies respiratoires, CHU de Bordeaux, groupe hospitalier sud, hôpital Haut-Leveque, avenue de Magellan, 33604 Pessac cedex, France; Service de pneumologie, CHU Sud Réunion, GHSR, avenue Président-Mitterrand, 97410 Saint-Pierre, Réunion. Electronic address: gaelle.peret@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Peret
authors.affiliation: Service des maladies respiratoires, CHU de Bordeaux, groupe hospitalier sud, hôpital Haut-Leveque, avenue de Magellan, 33604 Pessac cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Picard
authors.affiliation: Unité d'imagerie thoracique et cardiovasculaire, service d'imagerie médicale-radiologie diagnostique et thérapeutique, CHU de Bordeaux, groupe hospitalier sud, hôpital Haut-Leveque, avenue de Magellan, 33604 Pessac cedex, France.
authors.forename: O
authors.initials: O
authors.lastname: Corneloup
authors.affiliation: Service d'anatomie et de cytologie pathologiques, CHU de Bordeaux, groupe hospitalier sud, hôpital Haut-Leveque, avenue de Magellan, 33604 Pessac cedex, France.
authors.forename: H
authors.initials: H
authors.lastname: Begueret
authors.affiliation: Service des maladies respiratoires, CHU de Bordeaux, groupe hospitalier sud, hôpital Haut-Leveque, avenue de Magellan, 33604 Pessac cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Raherison-Semjen
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D003453:Cryptococcosis / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis*; D009894:Opportunistic Infections / Q000175:diagnosis; D017565:Sarcoidosis, Pulmonary / Q000150:complications*
keywords: Antifongiques; Antifungal therapy; Cryptococcal infection; Cryptococcose; Cryptococcus neoformans; Crytococcus neoformans; Immunodépression; Immunosuppression; Sarcoidosis; Sarcoïdose