<i>Cryptococcus </i>infection with asymptomatic diffuse pulmonary disease in an immunocompetent patient: A case report

Li, Yong; Fang, Lei; Chang, Fang-Qun; Xu, Fangzhou; Zhang, Yanbei

doi:10.12998/wjcc.v9.i11.2619

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…The PC sections of GMS (+) and PAS (−) cases revealed a single or several Cryptococcus that were dispersed. Li et al (2021) reported a case of pulmonary cryptococcal infection in a patient with normal immune function and a small amount of fungi with positive GMS and negative PAS staining. In contrast, GMS staining with bright green counterstaining clearly revealed brown-black Cryptococcus against the green background.…”

Section: Discussionmentioning

confidence: 99%

Grocott Methenamine Silver Staining Is the Optimal Approach to Histological Diagnosis of Pulmonary Cryptococcosis

Wang

Lai

et al. 2022

Front. Microbiol.

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BackgroundHistological staining methods for Cryptococcus identification vary in accuracy. This study aimed to investigate the clinical value of Grocott methenamine silver (GMS), periodic acid-Schiff (PAS), and Alcian blue (AB) staining in the diagnosis of pulmonary cryptococcosis (PC).MethodsFrom April 2004 to June 2021, the clinical and pathological data of 152 patients with PC were collected from the Department of Pathology, Sun Yat-sen University Cancer Center. The sensitivity and identifiability of GMS, PAS, and AB staining for histological diagnosis were systematically evaluated using statistical methods combined with the microscopic characteristics of PC cases.ResultsStatistical analysis showed that the detection rates of GMS, PAS, and AB staining were 100.0% (152/152), 94.7% (144/152), and 81.6% (124/152), respectively. McNemar’s test showed that the sensitivity of GMS was significantly higher than those of PAS (P = 0.008) and AB stains (P < 0.001). Both PAS and AB stains had obvious non-specific staining, which interfered with the detection of Cryptococcus, and increased diagnostic difficulties. In contrast, in GMS staining, Cryptococcus spores were prominent with a clean background and were clearly observed at low or medium power magnification, with the identifiability significantly better than those of PAS or AB staining.ConclusionGMS staining had sensitivity up to 100%, and identifiability that was better than those of PAS and AB staining. GMS is the best method for histological diagnosis of PC.

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Section: Discussionmentioning

confidence: 99%

Grocott Methenamine Silver Staining Is the Optimal Approach to Histological Diagnosis of Pulmonary Cryptococcosis

Wang

Lai

et al. 2022

Front. Microbiol.

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“…Huang J et al reported a case series of eight patients with concomitant lung adenocarcinoma and cryptococcal pneumonia [14]. There have been other cases of similar presentation reported in the literature [15,16]. This may be due to the immune system of patients with adenocarcinoma not functioning the same way as that of a patient without cancer [17].…”

Section: Discussionmentioning

confidence: 99%

Cryptococcal Pneumonia in an Immunocompetent Patient: A Rare Occurrence

Haider¹,

Master²,

Mahtani³

et al. 2022

Cureus

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Cryptococcosis is an invasive yeast infection commonly found among immunosuppressed patients. Pulmonary cryptococcal infection can have variable presentations ranging from pulmonary nodules and masses to consolidation. A patient can present with shortness of breath, cough, sputum production, chest pain, fatigue, and weight loss. Diagnosis can be made using fungal culture, histology, radiographic findings, and cryptococcal antigen in serum as well as in the cerebrospinal fluid. Treatment is usually with a combination or a single antifungal agent. Few cases have been reported in immunocompetent individuals.Here we present a case of 69-year-old immunocompetent individual, who was initially seen in the outpatient clinic for dyspnea, cough, and fatigue and was treated for pneumonia. The patient remained symptomatic despite multiple courses of oral antibiotics. He was then sent for inpatient admission. CT scan was obtained that showed patchy infiltrates and consolidations, followed by bronchoscopy. The cytology confirmed adenocarcinoma. The fungal smear and culture grew Cryptococcus neoformans. The patient was treated with fluconazole with improvement of his symptoms before starting chemotherapy.We are reporting this case as clinicians usually focus on bacterial etiologies in outpatient setting. Our patient, who was immunocompetent, had a new diagnosis of cryptococcal pneumonia and was also found to have lung adenocarcinoma. This case highlights the rare occurrence of this type of pneumonia in immunocompetent patients and the importance of considering fungal causes of pneumonia in patients.

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Cryptococcus infection with asymptomatic diffuse pulmonary disease in an immunocompetent patient: A case report

Cited by 2 publications

References 20 publications

Grocott Methenamine Silver Staining Is the Optimal Approach to Histological Diagnosis of Pulmonary Cryptococcosis

Grocott Methenamine Silver Staining Is the Optimal Approach to Histological Diagnosis of Pulmonary Cryptococcosis

Cryptococcal Pneumonia in an Immunocompetent Patient: A Rare Occurrence

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