A case of pulmonary cryptococcosis with large pericardial effusion diagnosed using cervical lymph node biopsy

Abstract

Pulmonary cryptococcosis (PC) is a relatively rare infectious disease. It mainly involves the lungs; however, in some patients, the infection could spread to other parts of the body. PC mostly occurs in patients with immune deficiencies. However, PC infections have been reported in non-immunocompromised patients. The diagnosis of PC is challenging in patients without immune deficiencies. Here, the case of a 27-year-old immunocompetent woman who was diagnosed with PC was report. She had unexplained fever and a history of close contact with poultry feathers. Lesions were observed in the lungs, pleural cavity, pericardium, and cervical lymph nodes. Biopsy of the cervical lymph nodes helped in the pathological diagnosis of PC. She was treated with fluconazole, and the lesions disappeared. They present this case to encourage detailed inquiry of medical history in such patients, improve the diagnostic awareness of clinicians, and help reduce the likelihood of misdiagnosis.

Fulminant Cryptococcus neoformans infection with fatal pericardial tamponade in a patient with chronic myelomonocytic leukaemia who was treated with ruxolitinib: Case report and review of fungal pericarditis

“…A third reported case described a 20‐year‐old patient with cystic fibrosis following lung transplant who developed pericardial effusion secondary to C. neoformans . Others have reported large pericardial effusion associated with pulmonary cryptococcosis, pericarditis associated with cryptococcal meningitis, pulmonary cryptococcosis with endotracheal invasion and pericardial effusion, pericardial cryptococcal disease in acquired immune deficiency syndrome (AIDS), as well as endoscopic ultrasound‐guided pericardiocentesis in a patient with disseminated cryptococcus infection . Although our patient had active chronic myelomonocytic leukaemia, a low‐risk leukaemia for fungal infections, he had several risk factors, such cytopenia and importantly prior treatment with ruxolitinib, a JAK ½ inhibitor implicated in severe opportunistic infections such as mycobacterial, Pneumocystis jirovecii , VZV, PML infections and a case of C. neoformans pneumonia .…”

“…[24][25][26][27] Pericardial involvement by C. neoformans is extremely rare, with few cases reported in the literature. 28 Others have reported large pericardial effusion associated with pulmonary cryptococcosis, 29 pericarditis associated with cryptococcal meningitis, 30 pulmonary cryptococcosis with endotracheal invasion and pericardial effusion, 31 pericardial cryptococcal disease in acquired immune deficiency syndrome (AIDS), 32 as well as endoscopic ultrasound-guided pericardiocentesis in a patient with disseminated cryptococcus infection. 33 Although our patient had active chronic myelomonocytic leukaemia, a low-risk leukaemia for fungal infections, 34…”

Cryptococcal pericarditis in a heart transplant recipient

“…[1][2][3] Pericardial cryptococcal infection, however, is rare, and few case reports have been described in the literature (see Tables 1 and 2). [4][5][6][7][8][9][10][11][12][13] Cryptococcal pericarditis has been described in patients with SOT as well as non-transplant patients (see Tables 1 and 2). [4][5][6][7][8][9][10][11][12][13] Among F I G U R E 1 A, An anterior pericardial effusion marked by the * that was seen on the parasternal long axis views on transthoracic echocardiography.…”

Cryptococcusneoformans pericarditis in a lung transplant recipient: Case report, literature review and pearls

“…Of these reports, two describe cryptococcal pericarditis in SOTR (lung and liver), four in patients with other immunosuppressive conditions (1 patient each had: AIDS, Hodgkin lymphoma, chronic myelomonocytic leukemia, and myasthenia gravis on immunosuppressants). The remaining 3 cases are described in otherwise healthy individuals: 40‐year‐old female with intravenous drug abuse; 25‐year‐old man with cryptococcal meningitis and pericarditis; and 27‐year‐old feather worker . Summary of cases can be found in Table .…”