Solitary cavitary pulmonary nodule may be a common CT finding in AIDS-associated pulmonary cryptococcosis

Hu, Zhiliang; Xu, Chuanjun; Wei, Hongxia; Zhong, Yan-Dan; Bo, Chunqin; Chen, Yun; Chen, Cong; Yang, Yongfeng

doi:10.3109/00365548.2012.749422

Cited by 11 publications

(13 citation statements)

References 16 publications

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“…Based on the available patients' data, at least 76.8% (43/56) of the nodular lesions could be demonstrated a relationship with PC. Those findings were closely consistent with our previous observation which suggested that solitary cavitary pulmonary nodule may be a common CT finding in HIV-associated PC[8]. Nevertheless, pulmonary nodular lesions with or without cavitation, although reported in other studies, were not recognized as common manifestations of HIV-associated PC [6, 7, 10].…”

Section: Discussionsupporting

confidence: 92%

“…In our previous study, we evaluated 11 HIV-infected patients with pulmonary abnormalities on chest CT scan and confirmed cryptococcal diseases outside of the lung. Interestingly, 9 patients had solitary pulmonary nodules that could be clinically related to cryptococcal infection [8]. This finding is inconsistent with the dominant perception of HIV-associated PC and necessitates further investigation.…”

Section: Introductionmentioning

confidence: 99%

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Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients

Wang

Xiong

et al. 2017

PLoS ONE

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BackgroundCurrent understanding of human immunodeficiency virus (HIV)-associated pulmonary cryptococcosis (PC) is largely based on studies performed about 2 decades ago which reported that the most common findings on chest radiograph were diffuse interstitial infiltrates. Few studies are available regarding the computed tomography (CT) findings. The aim of this study was to characterize chest CT features of HIV-associated PC.MethodsHIV patients with cryptococccal infection and pulmonary abnormalities on Chest CT between September 2010 and May 2016 in the Second Affiliated Hospital of the Southeast University were retrospectively analyzed. Confirmed cases of tumors, mycobacterial infections and other fungal infections were excluded from the analysis.Results60 cases were identified. The median CD4 T-cell counts were 20 cells/μL (range, 0–205 cells/μL). Chest CT scans demonstrated nodular lesions in 93.3% of the studied patients. Those nodular lesions were usually cavitated and solitary nodule was the most common form. Pleural effusions and pneumonic infiltrates occurred in 11.6% and 31.7% of the cases respectively. Those lesions were usually had co-existing nodular lesions. Etiological analysis suggested that 76.8% of the nodular lesions could have a relationship with PC that 12.5% of the nodular lesions were “laboratory-confirmed” cases, 48.2% were “clinically confirmed” cases and 16.1% were “clinically probable” cases. 85.7% of the pleural effusions could be “clinically confirmed” cases of PC. At least, 38.5% of the diffuse pneumonic infiltrates may be clinically attributed to pneumocystis pneumonia.ConclusionsThis study suggested that pulmonary nodules but not diffuse pneumonia are the most common radiological characteristics of HIV-associated PC. HIV-infected patients with pulmonary nodules on Chest CT should particularly be screened for cryptococcal infection.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients

Wang

Xiong

et al. 2017

PLoS ONE

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“…Four cases of CM with good prognosis were early diagnosed before the onset of any neurologic symptoms. The patients were screened for cryptococcus infection because of the presence of pulmonary cavitary nodules, which were regarded as common lesions of HIVassociated pulmonary cryptococcosis (16). As mannitol was not used, these four patients were excluded from analysis.…”

Section: Patient Characteristicsmentioning

confidence: 99%

The use of mannitol in HIV-infected patients with symptomatic cryptococcal meningitis

Yang

Cheng

et al. 2016

DD&T

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“…This presents a dilemma for physicians and illuminates the importance of pertinent history, including exposures, in narrowing down the differential. In cases with nonnecrotizing granulomatous inflammation, noninfectious etiologies were more frequent . In addition, the incidence of the disease in the general population is poorly described and is primarily in the immunocompromised population .…”

Section: Introductionmentioning

confidence: 99%

“…In cases with nonnecrotizing granulomatous inflammation, noninfectious etiologies were more frequent. 1,2 In addition, the incidence of the disease in the general population is poorly described and is primarily in the immunocompromised population. 1 Of the infectious etiologies, pulmonary Cryptococcus is the most common cause of pulmonary infections in AIDS patients, which is rarely reported in pediatric oncology literature.…”

Section: Introductionmentioning

confidence: 99%

Multiple unusual lung etiologies in a child with acute lymphocytic leukemia

Bechtel

Joyce

Dudek

et al. 2016

Pediatric Blood & Cancer

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Granulomatous lung disease is a rare and perplexing differential in pediatrics. Pulmonary Cryptococcus falls into the differential but is not high on the list, particularly in a non-AIDS patient. Methotrexate (MTX) is a commonly used agent for chemotherapy in oncology and has been documented to cause lung injury in both patients with rheumatologic and oncologic diseases. Our patient had chronic cough and then developed an opportunistic infection resulting in respiratory failure. Lung biopsy showed two underlying unusual diagnoses: MTX lung injury and cryptococcal pneumonia. His case is presented with particular attention to his prolonged road to diagnosis.

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Solitary cavitary pulmonary nodule may be a common CT finding in AIDS-associated pulmonary cryptococcosis

Abstract: Solitary cavitary pulmonary nodule may be a common CT finding in AIDS-associated PC. All AIDS patients with solitary cavitary pulmonary nodules on chest CT should be screened for Cryptococcus infection.

Cited by 11 publications

References 16 publications

Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients

Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients

The use of mannitol in HIV-infected patients with symptomatic cryptococcal meningitis

Multiple unusual lung etiologies in a child with acute lymphocytic leukemia

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