Cryptococcosis: an unusual cause of endobronchial obstruction

Mahida, P; Morar, Rajen; Mahomed, Akhter Goolam; Song, Eunseok; Tissandie, JP; Feldman, Charles

doi:10.1183/09031936.96.09040837

Cited by 24 publications

(18 citation statements)

References 4 publications

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“…Humans become infected with inhalation of basidiospores having small polysaccharide capsules, thus facilitating deposition in the alveoli and terminal bronchioles [77,78,79,80,81,82,83,84,85,86,87,88]. The reported incidence of new cases of cryptococcosis is 1.9 in males and 0.26 in females per 100,000 population in an endemic region such as California, and 0.02–0.03 in other parts of the USA [121].…”

Section: Discussionmentioning

confidence: 99%

“…Predisposing conditions for systemic infection include human immunodeficiency virus infection, malignancy, cirrhosis, renal failure, chronic lung diseases, diabetes mellitus, sarcoidosis, stem cell and solid organ transplantation, sickle cell disease and steroid therapy [77,78,79,80,81,82,83,84,85,86,87,88]. However, among 13 cases of EB Cryptococcus , only 3 (23%) were immunocompromised with the underlying diseases of myocarditis, diabetes mellitus and acquired immunodeficiency syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…[1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45], Coccidioides immitis [46] , agents of zygomycosis [6,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73], Candida spp. [6, 34,74,75,76], Cryptococcus neoformans [77,78,79,80,81,82,83,84,85,86,87,88], and Histoplasma capsulatum [89,90,91,92...…”

Section: Introductionmentioning

confidence: 99%

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Endobronchial Fungal Disease: An Under-Recognized Entity

Karnak

Avery²,

Gildea

et al. 2006

Respiration

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Most fungi enter the human body via inhalation; however, endobronchial fungal infection (EBFI) seems to be a rare manifestation compared to pulmonary or systemic disease. This presentation seems to be related to environmental factors as well as to the host status. With the increasing popularity of flexible bronchoscopy, it is being recognized with a higher frequency. Bronchoscopic findings in EBFI vary from mild mucosal inflammation to central airway obstruction. We searched English literature related to the topic and found 228 total cases of EBFI: Aspergillus species (121), Coccidioides immitis (38), Zygomycetes (31), Candida species (14) Cryptococcus neoformans (13), and Histoplasma capsulatum (11). We have also included a single case of endobronchial Pseudallescheria boydii infection in a lung transplant recipient that has not been reported previously. Most patients were immunocompromised, exhibited systemic manifestations of the primary infection, and responded to appropriate therapy. EBFI should be included in the differential diagnosis of any form of airway lesions in immunocompromised patients, especially among residents from the endemic areas.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endobronchial Fungal Disease: An Under-Recognized Entity

Karnak

Avery²,

Gildea

et al. 2006

Respiration

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“…We experienced a case of pulmonary cryptococcosis in which a bronchoscopic examination showed polypoid lesions with a smooth surface in the bronchial lumen. Because cases of endobronchial lesions with decreased lung volume or atelectasis are rare (4,5), we herein report this case and review cases of pulmonary cryptococcosis with endobronchial lesions.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Cryptococcosis with Endobronchial Lesions and Meningitis

Odashima¹,

Takayanagi²,

Ishiguro³

et al. 2014

Intern. Med.

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A 58-year-old man presented with right chest pain, anorexia, general malaise, and fever. Chest computed tomography showed a mass lesion with right middle lobe atelectasis. The bronchoscopy showed polypoid lesions with a smooth surface in each right middle lobe bronchial lumen. The histopathology revealed the dense accumulation of histiocyte-like cells with foamy cytoplasm under the bronchial epithelium along with yeast-like fungi stained positively with both Alcian blue and Grocott's stains. Cryptococcus neoformans was cultured from the bronchial washings. We diagnosed the patient with pulmonary cryptococcosis with endobronchial lesions. The fluconazole treatment was changed to liposomal amphotericin-B and flucytosine after the diagnosis of cryptococcal meningitis. The minimum inhibitory concentration of the fungi suggested resistance to fluconazole and flucytosine. The lesion regressed after these treatments.

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“…There are only a few rare descriptions (1)(2)(3) of cryptococcus presenting itself as endobronchial lesions, which cause volume loss in the lung or lung collapse. We report a case of pulmonary cryptococcosis in an immunocompromised patient who had focal endobronchial lesions.…”

Section: Introductionmentioning

confidence: 99%