Clinical features of pulmonary cryptococcosis in non-HIV patients in Japan

Kohno, Shigeru; Kakeya, Hiroshi; Izumikawa, Koichi; Miyazaki, Taiga; Yamamoto, Yoshihiro; Yanagihara, Katsunori; Mitsutake, Kotaro; Miyazaki, Yoshitsugu; Maesaki, Shigefumi; Yasuoka, Akira; Tashiro, Takayoshi; Mine, Mariko; Uetani, Masataka; Ashizawa, Kazuto

doi:10.1016/j.jiac.2014.08.025

Cited by 70 publications

(74 citation statements)

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“…Our findings in immunocompetent individuals have expanded the value of serum CrAg in the diagnosis of diffuse lesion in immunocompetent patients, supporting the results of previous studies that the most common CT findings of pulmonary cryptococcosis was multiple pulmonary nodules/masses of different diameters [18][19][20][21]. Similar to previous reports, our study also found that the most common symptoms of pulmonary cryptococcosis patients included cough and sputum, [5,[22][23][24] with no significant specificity( Table 1). Our laboratory examinations, including leucocyte, neutrophil, lymphocyte, Hb and PLT levels, showed no significant difference between immunocompetent and immunodeficient groups ( Table 2).…”

Section: Discussionsupporting

confidence: 91%

Pulmonary Cryptococcosis: comparison of Cryptococcal antigen detection and radiography in Immunocompetent and Immunocompromised patients

et al. 2020

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Background: We compared the cryptococcal antigen detection and imaging findings between immunocompetent and immunocompromised patients in whom pulmonary cryptococcosis had been diagnosed. The aim of our study was to determine whether the patient's immune status and radiography affect the detection of cryptococcal antigen. Methods: According to whether they took immunosuppressive drugs or not, seventy and eight adult patients with pulmonary cryptococcosis were divided into two groups: the immunocompetent group and the immunocompromised group. According to the detection of CrAg, each group was divided into the CrAg+ group and the CrAg-group. Then, clinical records, laboratory examinations and computed tomography findings were collected and analyzed. Results:No difference was found in baseline characteristics, clinical symptoms, and laboratory investigations. By comparing CrAg detection in these two groups, it was found that the number of CrAg+ cases in the immunocompetent group was more than that in the immunocompromised group. And in the immunocompetent group, diffuse lesions were more common in CrAg+ group and limited lesions were more frequently observed in CrAg-group.Conclusions: The patient's immune status and radiography would affect the detection of cryptococcal antigen. And serum CrAg could be a useful tool for the diagnosis of pulmonary cryptococcosis in immunocompetent patients with extensive lung involvement.

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Section: Discussionsupporting

confidence: 91%

Pulmonary Cryptococcosis: comparison of Cryptococcal antigen detection and radiography in Immunocompetent and Immunocompromised patients

et al. 2020

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“…As discussed above, cryptococcal infection seems likely to cause localized pulmonary lesions in HIV-infected patients similar with that in HIV-negative patients [1–4], although cavitation of the nodules seems to be more common in HIV-infected patients. The imaging modality of Chest CT scan used in our study is more sensitive to reveal pulmonary lesions [15].…”

Section: Discussionmentioning

confidence: 99%

“…In human immunodeficiency virus (HIV)-negative patients, pulmonary cryptococcosis (PC) has been extensively studied and nodular masses are the most common radiological manifestations [1–4]. However, PC in HIV-infected is less well defined.…”

Section: Introductionmentioning

confidence: 99%

Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients

Wang

Xiong

et al. 2017

PLoS ONE

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BackgroundCurrent understanding of human immunodeficiency virus (HIV)-associated pulmonary cryptococcosis (PC) is largely based on studies performed about 2 decades ago which reported that the most common findings on chest radiograph were diffuse interstitial infiltrates. Few studies are available regarding the computed tomography (CT) findings. The aim of this study was to characterize chest CT features of HIV-associated PC.MethodsHIV patients with cryptococccal infection and pulmonary abnormalities on Chest CT between September 2010 and May 2016 in the Second Affiliated Hospital of the Southeast University were retrospectively analyzed. Confirmed cases of tumors, mycobacterial infections and other fungal infections were excluded from the analysis.Results60 cases were identified. The median CD4 T-cell counts were 20 cells/μL (range, 0–205 cells/μL). Chest CT scans demonstrated nodular lesions in 93.3% of the studied patients. Those nodular lesions were usually cavitated and solitary nodule was the most common form. Pleural effusions and pneumonic infiltrates occurred in 11.6% and 31.7% of the cases respectively. Those lesions were usually had co-existing nodular lesions. Etiological analysis suggested that 76.8% of the nodular lesions could have a relationship with PC that 12.5% of the nodular lesions were “laboratory-confirmed” cases, 48.2% were “clinically confirmed” cases and 16.1% were “clinically probable” cases. 85.7% of the pleural effusions could be “clinically confirmed” cases of PC. At least, 38.5% of the diffuse pneumonic infiltrates may be clinically attributed to pneumocystis pneumonia.ConclusionsThis study suggested that pulmonary nodules but not diffuse pneumonia are the most common radiological characteristics of HIV-associated PC. HIV-infected patients with pulmonary nodules on Chest CT should particularly be screened for cryptococcal infection.

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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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Clinical features of pulmonary cryptococcosis in non-HIV patients in Japan

Abstract: It is crucial to consider the presence of UDs and meningoencephalitis for the choice of antifungals and treatment duration for cryptococcosis in non-HIV patients. Three- and six months-administration of azoles for pulmonary cryptococcosis with or without UDs, respectively is reasonable.

Cited by 70 publications

References 17 publications

Pulmonary Cryptococcosis: comparison of Cryptococcal antigen detection and radiography in Immunocompetent and Immunocompromised patients

Pulmonary Cryptococcosis: comparison of Cryptococcal antigen detection and radiography in Immunocompetent and Immunocompromised patients

Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients

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

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Clinical features of pulmonary cryptococcosis in non-HIV patients in Japan

Abstract: It is crucial to consider the presence of UDs and meningoencephalitis for the choice of antifungals and treatment duration for cryptococcosis in non-HIV patients. Three- and six months-administration of azoles for pulmonary cryptococcosis with or without UDs, respectively is reasonable.

Cited by 70 publications

References 17 publications

Pulmonary Cryptococcosis: comparison of Cryptococcal antigen detection and radiography in Immunocompetent and Immunocompromised patients

Pulmonary Cryptococcosis: comparison of Cryptococcal antigen detection and radiography in Immunocompetent and Immunocompromised patients

Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients

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

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