title: Cavitary pulmonary cryptococcosis with an Aspergillus fungus ball.
abstract: We herein present the case of a 64-year-old immunocompetent man with a diagnosis of pulmonary cryptococcosis who presented with cavitary nodules, one of which contained a fungus ball, on chest CT. The coincidence of cavitary cryptococcosis and an Aspergillus fungus ball was histologically confirmed on a thoracoscopic lung biopsy. Encapsulated round-to-oval yeasts (Cryptococcus) were observed throughout the entire specimen, including the cavity, cavity wall and lung parenchyma. In contrast, filamentous fungi (Aspergillus) were noted within the cavity only. The probable mechanism of this rare manifestation is that the Cryptococcus formed cavities, after which an Aspergillus fungus ball developed within one cavity.
authors.affiliation: Department of Respiratory Medicine and Allergology, Kinki University, Faculty of Medicine, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Makino
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishiyama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sano
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwanaga
authors.forename: Yuji
authors.initials: Y
authors.lastname: Higashimoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kume
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tohda
mesh_terms: D000068879:Adalimumab; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D001999:Bronchoscopy; D003453:Cryptococcosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D003454:Cryptococcus / Q000302:isolation & purification*; D018450:Disease Progression; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008168:Lung / Q000382:microbiology* / Q000473:pathology; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D055732:Pulmonary Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D000935:Antifungal Agents; D015725:Fluconazole; D000068879:Adalimumab