Clinicopathological features of isolated pulmonary cryptococcosis in HIV-negative patients

Abstract

Objective To analyse the clinicopathological features of isolated pulmonary cryptococcosis in human immunodeficiency virus (HIV)-negative patients. Methods This retrospective study analysed the following data from HIV-negative patients diagnosed with pulmonary cryptococcosis: demographics, underlying diseases, clinical manifestations on admission, laboratory tests, imaging data, results of histopathology, treatment options and outcomes. Sputum samples from all patients were collected and assessed for the presence of yeast or fungi. Cryptococcal antigen testing was performed for some patients. Histopathological analysis was also undertaken for some samples of lung tissue. Results The study analysed 37 patients (22 males). Thirteen (35.14%) patients were asymptomatic, 24 (64.86%) were symptomatic and 17 (45.95%) patients had no underlying disease. Out of 25 tested patients, 23 (92.00%) tested positive on the serum cryptococcal capsular polysaccharide antigen test. During 6 to 24 months of follow-up, all 37 patients that were either treated with or without antifungal therapy alone or combined with surgical resection showed complete recovery. One patient made a full recovery without any treatment. Conclusion Early identification of pulmonary cryptococcosis in HIV-negative patients and timely detection of cryptococcal antigens in serum or respiratory specimens may help to improve diagnosis, prognosis and treatment of the disease.

Cryptococcus granuloma mimicking local progressed tumor after cryoablation of renal cell carcinoma: A case report

“…CT images obtained 11 months after the second CA showed remarkable shrinkage of the treated area. In the case of a pulmonary Cryptococcus infection, pulmonary nodules shrink with antifungal drugs [12] ; however, in our case, it was uncertain whether the shrinkage of the treated area was caused by fluconazole or repeated CA.…”

Clinical Diagnosis, Treatment, and Laboratory Detection of 50 Cases of Pulmonary Cryptococcosis

“…This study found that the clinical manifestations in 22 patients were nonspecific and difficult to be differentiated from tumors, inflammations, and other lesions. It can be concluded that the clinical manifestations of pulmonary cryptococcosis are heterogeneous and nonspecific [ 10 , 18 ].…”

Disseminated Cryptococcosis in an Immunocompetent Child

“…The mode of acquisition of cryptococcosis is by inhalation of the spores that get deposited in the smaller airways [ 4 ]. Most of the individuals with this early infection remain asymptomatic and it is self-limiting, but a small fraction of these patients may develop the symptomatic pulmonary disease [ 3 , 4 ]. Eventually, the fungus may disseminate from lungs to other sites of the body like the brain, peripheral lymph nodes, and skin.…”

“…The common risk factors for Cryptococcus infection include human immunodficiency virus (HIV) infection, primary inherited immunodeficiency disorders (PID), immunosuppressive therapy, transplantation, malignancies, and idiopathic CD4 lymphopenia [ 2 ]. Pulmonary cryptococcosis in immunocompetent individuals is often self-limiting and hitherto rarely requires hospitalization [ 3 ]. In individuals with a history of immunosuppression, the fungus may disseminate to other organs, including the central nervous system.…”