title: Clinical analysis of pulmonary cryptococcosis in non-HIV patients in south China.
abstract: OBJECTIVE
  The aim of this study was to investigate the clinical characteristics of pulmonary cryptococcosis occurring in non-HIV patients, and to develop early diagnosis of pulmonary cryptococcosis in immunocompetent cases as well.
  
  
  METHODS
  We retrospectively reviewed the clinical data of 41 non-HIV infected patients with pulmonary cryptococcosis who were admitted to the First Affiliated Hospital of Wenzhou Medical University from January 2006 to April 2014.
  
  
  RESULTS
  The study included a total of 41 patients (23 males and 18 females) with mean age of 47 years. 12.19% of patients had a history of direct exposure to pigeon droppings; 31.70% of the patients' working or living environments were potentially contaminated by fungal spores. Almost one-third of the patients involved into the study were asymptomatic. The most common clinical manifestations were cough, expectoration and hemoptysis. The most common radiological manifestation was single node or mass in lung, which was described as untypical. Of all cases, 11 patients were diagnosed by CT-guided percutaneous cutting needle biopsy (PCNB), 5 patients were diagnosed by operation, and Crytococcus spore was found in 7 patients' cerebrospinal fluid. 8 patients' blood Cryptococcus Neoformans capsular polysaccharide antigens latex agglutination tests were positive. 36 patients received antifungal therapy. 5 patients underwent surgical resection. During 6 to 24 months follow-up, 40 cases showed total recovery and 1 cases showed improvement.
  
  
  CONCLUSIONS
  Pulmonary cryptococcosis in non-HIV subjects might be related to fungus-contaminated environmental exposure. The great variations and protean manifestations of its clinical features often lead to misdiagnosis. Recognition and invasive examination of non-HIV infected patients' pulmonary cryptococcosis in the early stage may help with improvement of its diagnosis and prognosis.
authors.affiliation: Pulmonary Division, First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Xiaona
authors.initials: X
authors.lastname: Xie
authors.affiliation: Division of General surgery, First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Botao
authors.initials: B
authors.lastname: Xu
authors.affiliation: Division of Radiology, First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Yu
authors.affiliation: Pulmonary Division, First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Mayun
authors.initials: M
authors.lastname: Chen
authors.affiliation: Pulmonary Division, First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Yao
authors.affiliation: Pulmonary Division, First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Xu
authors.affiliation: Pulmonary Division, First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Xueding
authors.initials: X
authors.lastname: Cai
authors.affiliation: Pulmonary Division, First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Ding
authors.affiliation: Pulmonary Division, First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Liangxing
authors.initials: L
authors.lastname: Wang
authors.affiliation: Pulmonary Division, First Affiliated Hospital of Wenzhou Medical University Wenzhou, China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Huang
keywords: Pulmonary cryptococcosis; clinical characteristics; diagnosis; non-HIV patients; radiographic features