Cryptococcal pneumonia: the great mimicker

Thambidurai, Lasya; Prabhuradhan, R; Singhvi, Praveenkumar; Ilanchezhian, Subramanian; Ramachandran, Rajoo; Shankar, Haree

doi:10.1259/bjrcr.20150358

Cited by 4 publications

(9 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Comparatively to the other two types of infections, cryptococcal pneumonia is found in all adult age group patients. 29 A previous 20-year retrospective study from China reported a mean age of 49.3 (SD: 14.3) for cryptococcal pneumonia patients. 24 The occurrence of cryptococcal pneumonia in all age patients is solely related to the subject’s weakened immune systems.…”

Section: Discussionmentioning

confidence: 99%

Cryptococcosis in Southern China: Insights from a Six-Year Retrospective Study in Eastern Guangdong

Bilal,

Zhang,

Shafiq

et al. 2023

IDR

View full text Add to dashboard Cite

Objective Cryptococcosis is a fatal infection that can affect both immunocompetent and immunocompromised patients, and it is little understood in China’s various regions. This research aimed to look at the epidemiology, risk factors, and antifungal susceptibility pattern of Cryptococcus neoformans in eastern Guangdong, China. Methods A six-year (2016–2022) retrospective study was conducted at Meizhou People’s Hospital, China. Demographical, clinical, and laboratory data of cryptococcal patients were collected from hospital records and statistically analyzed using the chi-square and ANOVA tests. Results Overall, 170 cryptococcal infections were recorded, of which meningitis accounted for 78 (45.88%), cryptococcemia for 50 (29.41%), and pneumonia for 42 (24.7%). The number of cases increased 8-fold during the study duration. The median age of patients was 58 years (Inter quartile range: 47–66), and the high proportion of cases was from the male population (n = 121, 71.17%). The underlying diseases were identified only in 60 (35.29%) patients, of which 26 (15.29%) were severely immunocompromised, and 26 (15.29%) others were mildly immunocompromised. A statistically significant difference was reported for chronic renal failure, and anemia ( p < 0.05) persisted in cases of three infection types. A high number of non-wild type (NWT) isolates were found against amphotericin B (n=13/145, 8.96%), followed by itraconazole (n=7/136, 5.15%) and voriconazole (n=4/158, 2.53%). Only six isolates (3.79%) were multidrug-resistant, four of which were from cryptococcemia patients. Compared to meningitis and pneumonia, cryptococcemia revealed a higher percentage of NWT isolates ( p < 0.05). Conclusion In high-risk populations, cryptococcal infections require ongoing monitoring and management.

show abstract

Section: Discussionmentioning

confidence: 99%

Cryptococcosis in Southern China: Insights from a Six-Year Retrospective Study in Eastern Guangdong

Bilal,

Zhang,

Shafiq

et al. 2023

IDR

View full text Add to dashboard Cite

show abstract

“…In one case, there was a disseminated miliary/reticulonodular pattern which was diagnosed as cryptococcal pneumonia after axillary lymph node biopsy. It was concluded that in immunocompromised patients with multiple pulmonary nodules, cryptococcal pneumonia, Pneumocystis carinii pneumonia, and mycobacterial infections should be considered in the differential diagnosis of pulmonary infections [23].…”

Section: Discussionmentioning

confidence: 99%

Atypical Radiographic Presentation of Cryptococcus Pneumonia in a Newly Diagnosed HIV Patient

Cacacho

Ashraf

Rehmani

et al. 2019

Case Reports in Infectious Diseases

View full text Add to dashboard Cite

Background. Cryptococcus infection is an opportunistic infection that occurs primarily among immunocompromised patients, and the morbidity and mortality of this infection is high if left unrecognized and untreated. There are no clinical or radiographic characteristics typical of cryptococcal pneumonia, and its clinical and radiological presentations often overlap with other diagnoses. Case Presentation. We present a case of a 25-year-old man from Ghana admitted for an altered mental state, weight loss, neck pain, fever, and photophobia. He was diagnosed with Cryptococcus neoformans meningitis by cerebrospinal fluid culture and with disseminated cryptococcal infection by a positive Cryptococcus blood test. Diffuse micronodular opacities were found in a miliary pattern in the upper portions of both lungs upon imaging, which suggested miliary tuberculosis; thus, the patient was started on antituberculosis therapy. The patient underwent flexible fiber optic bronchoscopy, and transbronchial biopsy of the right lung showed bronchopneumonia with fungal spores consistent with filamentous Cryptococcus neoformans, which grew in tissue culture of the right lung. Interferon-gamma release assay, Mycobacterium tuberculosis PCR, and acid-fast bacilli staining of the bronchoalveolar lavage were negative for the M. tuberculosis complex. Conclusion. The similarities in clinical and imaging findings among patients with acute immunodeficiency syndrome with coinfections make diagnoses difficult; thus image-guided biopsies are essential to confirm diagnoses.

show abstract

“…The imaging features of cryptococcal infection tend to mimic other pathological conditions. A case report reviewing the presentation among two immunosuppressed patients and one immunocompetent patient revealed the difficulty in diagnosing cryptococcal pneumonia based on radiological findings alone [ 6 ]. One immunocompromised patient presented with nodular opacities in bilateral lung fields on chest X-ray and enlarged lymph nodes in the mediastinum and axillary regions on CT scan [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…A case report reviewing the presentation among two immunosuppressed patients and one immunocompetent patient revealed the difficulty in diagnosing cryptococcal pneumonia based on radiological findings alone [ 6 ]. One immunocompromised patient presented with nodular opacities in bilateral lung fields on chest X-ray and enlarged lymph nodes in the mediastinum and axillary regions on CT scan [ 6 ]. A CT scan of the thorax in the second immunocompromised patient demonstrated a mass in the right lower lobe of the lungs mimicking a malignant lesion [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…One immunocompromised patient presented with nodular opacities in bilateral lung fields on chest X-ray and enlarged lymph nodes in the mediastinum and axillary regions on CT scan [ 6 ]. A CT scan of the thorax in the second immunocompromised patient demonstrated a mass in the right lower lobe of the lungs mimicking a malignant lesion [ 6 ]. In contrast, the immunocompetent patient presented with ring-enhancing lesions with surrounding edema on a CT scan of the brain and enlarged mediastinal lymph nodes on a CT of the thorax [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary Cryptococcosis: A Diagnostic and Management Challenge Case Report

Cardoso,

Carroll

2024

Cureus

View full text Add to dashboard Cite

Cryptococcosis is a fungal infection that may arise in immunocompromised or immunocompetent individuals. This case report seeks to demonstrate the difficulty in diagnosing and treating cryptococcosis based on clinical presentation and radiographic features as together, they mimic other pathological conditions. A 56-year-old female with cirrhosis presented with persistent abdominal pain, dyspnea, vomiting, and diarrhea and was diagnosed with pulmonary cryptococcosis after an initial diagnosis of bacterial pneumonia. With no improvement following antibiotic therapy for suspected bacterial pneumonia, additional imaging was performed with a confirmatory lung biopsy for pulmonary cryptococcosis. The patient initiated antifungal therapy with the anticipation of completing approximately 12 months with follow-up imaging to evaluate improvement. After the patient experienced adverse effects of antifungal therapy and did not achieve significant improvement or recovery in her condition, it was apparent that cryptococcal pneumonia presents both diagnostic and management challenges that must be further explored.

show abstract

Cryptococcal pneumonia: the great mimicker

Cited by 4 publications

References 18 publications

Cryptococcosis in Southern China: Insights from a Six-Year Retrospective Study in Eastern Guangdong

Cryptococcosis in Southern China: Insights from a Six-Year Retrospective Study in Eastern Guangdong

Atypical Radiographic Presentation of Cryptococcus Pneumonia in a Newly Diagnosed HIV Patient

Pulmonary Cryptococcosis: A Diagnostic and Management Challenge Case Report

Contact Info

Product

Resources

About