title: Fatal disseminated cryptococcosis resembling miliary tuberculosis in a patient with HIV infection.
abstract: A 51-year-old man was transferred to our hospital due to acute respiratory failure that had progressed over four days. A chest X-ray and thoracic computed tomography scan showed multiple faint micronodules randomly distributed throughout both lungs with ground glass opacity, suggesting miliary tuberculosis or Pneumocystis jirovecii pneumonia with acute respiratory distress syndrome. Six hours after admission, the patient died of septic shock. Later, the cryptococcal antigen titer was found to be markedly elevated (1/65,536), with a positive result for anti-human immunodeficiency virus and a low CD4 cell count (12/μL). The present case is reminder that disseminated cryptococcosis with HIV infection can be misdiagnosed as miliary tuberculosis based on radiological findings.
authors.affiliation: Department of Respiratory Medicine, Kyorin University School of Medicine, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Shimoda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Saraya
authors.forename: Naoki
authors.initials: N
authors.lastname: Tsujimoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kurai
authors.forename: Hajime
authors.initials: H
authors.lastname: Takizawa
authors.forename: Hajime
authors.initials: H
authors.lastname: Goto
mesh_terms: D003453:Cryptococcosis / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D017809:Fatal Outcome; D006678:HIV; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014391:Tuberculosis, Miliary / Q000150:complications* / Q000175:diagnosis