Clinical analysis of non-AIDS patients pathologically diagnosed with pulmonary cryptococcosis

Liu, Kaixiong; Ding, Haibo; Xu, Bing; You, Ruixiong; Zhang, Xing; Chen, Jianfeng; Lin, Qichang; Qu, Jieming

doi:10.21037/jtd.2016.10.36

Cited by 61 publications

(71 citation statements)

References 25 publications

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“…[ 6 7 8 9 ] In radiography, some studies reported that chest radiological findings of pulmonary cryptococcosis were untypical and varied. [ 6 22 23 ] Many studies found that pulmonary nodules and mass were more common. [ 6 8 24 ] Lindell et al .…”

Section: Discussionmentioning

confidence: 99%

Extent of Lung Involvement and Serum Cryptococcal Antigen Test in Non-Human Immunodeficiency Virus Adult Patients with Pulmonary Cryptococcosis

Zhu

Luo

Chen

et al. 2018

Chinese Medical Journal

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Background:Serum cryptococcal antigen (CrAg) test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this study was to investigate the factors associated with false-negative CrAg test among non-human immunodeficiency virus (HIV) adult patients with pulmonary cryptococcosis and its clinical features.Methods:One hundred and fourteen non-HIV adult patients with pulmonary cryptococcosis, proven by biopsy, were retrospectively reviewed. Finally, 85 patients were enrolled; 56 were CrAg positive (CrAg+ group) and 29 were negative (CrAg− group). It was a cross-sectional study. Then, baseline characteristics, underlying diseases, clinical symptoms, laboratory findings, and chest radiological findings were reviewed and analyzed. Chi-square test was used to analyze categorical variable. Odds ratio (OR) was used to measure correlation. Student's t-test was obtained to analyze continuous variable.Results:No difference in baseline characteristics, underlying diseases, clinical symptoms, and laboratory findings were found between two groups (P > 0.05 in all). Nevertheless, diffuse extent lesion was 82.1% in CrAg+ group and 10.3% in CrAg− group (χ2= 40.34, P < 0.001; OR = 39.87).Conclusions:Among patients with limited pulmonary involvement, a negative serum CrAg does not preclude the diagnosis of pulmonary cryptococcosis. However, among patients with extensive pulmonary involvement, serum CrAg is a useful diagnostic tool for pulmonary cryptococcosis. Furthermore, we also noticed that the untypical and mild presentations with extensive pulmonary lesion might be the features of pulmonary cryptococcosis, which needs further investigation.

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Section: Discussionmentioning

confidence: 99%

Extent of Lung Involvement and Serum Cryptococcal Antigen Test in Non-Human Immunodeficiency Virus Adult Patients with Pulmonary Cryptococcosis

Zhu

Luo

Chen

et al. 2018

Chinese Medical Journal

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“…to cause endovascular infection and endocarditis is very low. Interestingly, cryptococcosis occurs more frequently in immunocompetent patients than in immunocompromised patients in China [7][8][9][10] . The mechanism of this is not clear.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of HIV-negativepatients with cryptococcemia in a Chinese tertiary-care hospital:  A 10-year study

Liang¹,

Liang²,

Chen³

2020

Preprint

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Objective: Cryptococcosis is a severe opportunistic fungal infection. Cryptococcemia is a rare manifestation of cryptococcosis with high mortality. Objective: To characterize patients with cryptococcemia in Chinese PLA General Hospital since 2010 to 2019.Methods: We identified retrospectively those blood cultures with Cryptococcus sp. growth, and then obtained their clinical information which were analyzed by two independent reviewers.Results: A total of 8 patients withcryptococcemiawere identified, of which only 2 patients survived.There were 3 males and 5 females, whose age ranged from 23 to 72 years. They were all HIV negative. 1 (12.5%) had ovarian adenocarcinoma, 2 (25%) had systemic lupus erythematosus, 3 (37.5%) had primary nephrotic syndrome, 1 (12.5%) had viral myocarditis, and 1 (12.5%) were after lung transplantation. The most common symptoms were fever (100%) and confusion (50%). Out of the 8 episodes, 6 (60%) had meningeal infection and 2 (25%) presented as pulmonary involvement meanwhile. Six patients were dead at half a year follow up.Conclusions: Cryptococcemia is an unusual infection characterized by a high mortality. It requires early identify and prompt antifungal therapy.

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“…The most frequent symptoms in our patients with pulmonary cryptococcosis included cough and expectoration were also found in our series and in those in previously published reports. [4,[16][17][18][19] Our data on laboratory findings, including WBC, neutrophils, Hb, PLT, and plasma PCT level suggested that there were no significant difference between two groups (Table 1). It may confirm that cryptococcosis could dampen pulmonary neutrophil recruitment and inflammatory cytokine production in immunocompetent hosts, which affects the immunity of a healthy subject.…”

Section: Discussionmentioning

confidence: 99%

“…Pulmonary cryptococcosis caused by infection with Cryptococcus neoformans C. Cryptococcus complexes is common in patients with immune dysfunction and it has become a emerging disease in patients with good immune function. [1][2][3]Some reports [4,5] revealed that pulmonary cryptococcosis occurs more frequently in immunocompetent patients than in immunocompromised patients.…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting the False Negative of Cryptococcal antigen in Patients with Cryptococcosis: Immunology and Radiology

j¹,

Huang²,

c³

et al. 2019

Preprint

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Study objectivesThe purpose of this article is to investigate the factors associated with false negatives in cryptococcal antigen detection in patients with pulmonary cryptococcosis by studying the effects of immune status and radiology on cryptococcal antigen results. MethodsThe clinical records, serum cryptococcal antigen result, laboratory findings and computed tomography findings of 61 immunocompetent and 17 immunocompromised patients with a diagnosis based on biopsy confirmation of the presence of pulmonary cryptococcosis were reviewed during the course of the study. Chi-square test was used to analyze categorical variable. The independent t-test was obtained to analyze continuous variable. Logistic regression models was used to analyze the effects of immunity and radiology imaging on cryptococcal antigen results. ResultsWe studied the differences between these two groups. No difference were found in baseline characteristics, clinical symptoms, and laboratory findings. Logistic regression analysis showed that the significant independent variables related to serum cryptococcal antigen result were the immune status and radiology findings. ConclusionsOur study indicates that immune status and lung imaging findings are important factors influencing cryptococcal antigen detection.

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Clinical analysis of non-AIDS patients pathologically diagnosed with pulmonary cryptococcosis

Abstract: PC was not rare in immunocompetent host in southern China. Special differences remained in clinical manifestation and radiological findings of PC between immunocompromised and immunocompetent patients. Future work on the mechanisms of possible differences is required.

Cited by 61 publications

References 25 publications

Extent of Lung Involvement and Serum Cryptococcal Antigen Test in Non-Human Immunodeficiency Virus Adult Patients with Pulmonary Cryptococcosis

Extent of Lung Involvement and Serum Cryptococcal Antigen Test in Non-Human Immunodeficiency Virus Adult Patients with Pulmonary Cryptococcosis

Clinical characteristics of HIV-negativepatients with cryptococcemia in a Chinese tertiary-care hospital:  A 10-year study

Factors Affecting the False Negative of Cryptococcal antigen in Patients with Cryptococcosis: Immunology and Radiology

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Clinical analysis of non-AIDS patients pathologically diagnosed with pulmonary cryptococcosis

Abstract: PC was not rare in immunocompetent host in southern China. Special differences remained in clinical manifestation and radiological findings of PC between immunocompromised and immunocompetent patients. Future work on the mechanisms of possible differences is required.

Cited by 61 publications

References 25 publications

Extent of Lung Involvement and Serum Cryptococcal Antigen Test in Non-Human Immunodeficiency Virus Adult Patients with Pulmonary Cryptococcosis

Extent of Lung Involvement and Serum Cryptococcal Antigen Test in Non-Human Immunodeficiency Virus Adult Patients with Pulmonary Cryptococcosis

Clinical characteristics of HIV-negativepatients with cryptococcemia in a Chinese tertiary-care hospital: A 10-year study

Factors Affecting the False Negative of Cryptococcal antigen in Patients with Cryptococcosis: Immunology and Radiology

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Clinical characteristics of HIV-negativepatients with cryptococcemia in a Chinese tertiary-care hospital:  A 10-year study