Plain and contrast‑enhanced chest computed tomography scan findings of pulmonary cryptococcosis in immunocompetent patients

Yang, Rongshui; Yan, Yan; Wang, Yuhuan; Liu, Xiaohuan; X, Su

doi:10.3892/etm.2017.5096

Cited by 10 publications

(12 citation statements)

References 29 publications

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“…Previous studies have also revealed that air-bubble sign, halo sign, and air bronchogram were common CT manifestations of PC. 22,23 It has been reported that a satellite lesion on chest CT could be a useful predictor for benign nodules, especially for tuberculomas. [24][25][26] In addition, accompanying centrilobular micronodules and cavity or necrosis were more frequently observed in tuberculomas.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Computed Tomography (CT) Characteristics of Pulmonary Nodules Caused by Cryptococcal Infection

Chen

Liu

et al. 2021

IDR

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To investigate the clinical and computed tomography (CT) characteristics of pulmonary nodules caused by cryptococcal infection and gain a greater insight and understanding that will reduce misdiagnosis. Materials and Methods: A total of 47 patients with confirmed pulmonary cryptococcosis (PC) manifested as nodules were retrospectively enrolled from January 2013 to December 2020. The clinical and CT data of patients with single and multiple nodules were analyzed and compared with emphasis on exploring the characteristics of the solitary ones. Results: Among the 47 patients, single and multiple nodules were detected in 25 (53.2%) and 22 (46.8%) patients, respectively, with similar clinical characteristics. The diameter of solitary nodules was smaller than that of the largest ones of the multiple nodules (P = 0.000). Compared with multiple nodules, less solitary nodules were located in the subpleural zone (P = 0.031) and had a cavity or vacuole (P = 0.049). Regarding the solitary nodules, 22 (88.0%) and 3 (12.0%) were solid and subsolid, respectively. Eighteen (81.8%) solid solitary nodules exhibited either one of air bronchogram or vacuole, satellite lesions, and halo sign. Twenty-three (92.0%) of 25 patients with solitary nodules had follow-up CT data, and most of them had no changes (12, 52.1%) or increased in size and/or density (8, 34.8%), but only a few (3, 13.0%) decreased with or without anti-inflammatory therapy. Conclusion:The clinical characteristics of patients with solitary and multiple nodules caused by PC are similar. The solitary nodules are smaller, more scattered, but less necrotic than multiple ones. For solitary nodules with air bronchogram or vacuole, satellite lesions, or halo sign, PC should be considered as one of the differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Clinical and Computed Tomography (CT) Characteristics of Pulmonary Nodules Caused by Cryptococcal Infection

Chen

Liu

et al. 2021

IDR

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“…In this study, the most characteristic manifestation was air bronchograms, accounting for 86%, consistent with previous reports. 13 The bronchus moved through the lesions naturally and smoothly and the distal bronchus gradually narrowed. These signs reflect the inviolability of the corresponding bronchi.…”

Section: Discussionmentioning

confidence: 98%

Characterization of Clinical and CT Manifestations of Pulmonary Cryptococcosis with Consolidation

Yang

Luo

et al. 2021

Arch Iran Med

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Considering the insufficient understanding of pulmonary cryptococcosis (PC) with consolidation, 22 patients were evaluated based on the chest computed tomography (CT) images and clinical manifestation. The clinical symptoms were mild, mainly manifesting as cough and sputum. Pulmonary lesions mostly involved a single lobe in a single lung with multiple lesions. Specifically, single lung involvement was observed in 17 cases, single lobe in 16 cases and multiple lesions in 14 case. Fifteen cases were mainly distributed in the periphery and 17 cases in the long axis in parallel to the pleura. Nineteen cases had air bronchograms. Eight cases displayed cavitation inside the lesions and 18 cases had surrounding halo signs. Seventeen cases had pleural thickening, of which 10 cases had "pasting wall" signs. The clinical symptoms of PC with consolidation were relatively mild. Comprehensive clinical and imaging performance could improve the diagnosis of the disease.

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“…54,93,94 Consolidations, cavitation, enlarged lymph nodes, and pleural effusions can occur in immunocompetent hosts, although less frequently. 49,95 A study that reviewed plain and contrast-enhanced CT scan findings of primary pulmonary cryptococcosis in 27 immunocompetent patients found that pulmonary nodules were the most common finding (40.7%), with multiple being more frequent than solitary (25.9 vs. 14.8%). 96 Most of the nodules were poorly defined and inhomogeneous.…”

Section: Radiologymentioning

confidence: 99%

“…On contrast-enhanced images, the majority of nodules presented ring enhancement, and the masses had inhomogeneous enhancement. 95 A study in 1998 reviewed the radiographs of 44 HIVnegative patients with proven cryptococcosis diagnosed by the identification of Cryptococcus neoformans in blood, sputum, CSF, or tissue using culture, histological examination, or antigen detection. 97 The most common findings in this cohort were pulmonary masses (solitary more frequent than multiple) and patchy airspace consolidations that often involved more than one lobe.…”

Section: Radiologymentioning

confidence: 99%

Cryptococcosis

Zavala

Baddley

2020

Semin Respir Crit Care Med

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Cryptococcosis has become an important infection in both immunocompromised and immunocompetent hosts. Although Cryptococcus is mainly recognized by its ability to cause meningoencephalitis, it can infect almost any organ of the human body, with pulmonary infection being the second most common disease manifestation. In cases of meningitis, symptom onset may be insidious, but headaches, fevers, or mental status changes should warrant diagnostic testing. Symptoms of pulmonary disease are nonspecific and may include fever, chills, cough, malaise, night sweats, dyspnea, weight loss, and hemoptysis. Due to protean manifestations of infection, diagnosis may be delayed or misdiagnosis may occur. Diagnosis typically is made by antigen testing of serum or cerebrospinal fluid or by culture or histopathology of infected tissues. A lumbar puncture with the measurement of opening pressure is recommended for patients with suspected or proven cryptococcosis. Treatment of cryptococcosis is based on the anatomical site of disease, severity of disease, and underlying immune status of the patient. Amphotericin B preparations plus 5-flucytosine is used as initial treatment of meningitis, disseminated infection, or moderate-to-severe pulmonary infection followed by fluconazole as a consolidation therapy. Fluconazole is effective for mild-to-moderate pulmonary infection. Important complications include elevated intracranial pressure and immune reconstitution syndrome, which may resemble active disease.

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Plain and contrast‑enhanced chest computed tomography scan findings of pulmonary cryptococcosis in immunocompetent patients

Cited by 10 publications

References 29 publications

Clinical and Computed Tomography (CT) Characteristics of Pulmonary Nodules Caused by Cryptococcal Infection

Clinical and Computed Tomography (CT) Characteristics of Pulmonary Nodules Caused by Cryptococcal Infection

Characterization of Clinical and CT Manifestations of Pulmonary Cryptococcosis with Consolidation

Cryptococcosis

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