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Pulmonary Cryptococcosis


Presentation

  • Eight cases presented with solitary and nine with multiple nodules, while 13 cases presented with irregular and 19 with ill-defined nodules. The halo sign was demonstrated, encompassing nodules in 14 of the 21 patients.[ncbi.nlm.nih.gov]
Asymptomatic
  • Isolated pulmonary cryptococcosis may be observed without specific therapy in asymptomatic immunocompetent hosts.[ncbi.nlm.nih.gov]
Fever
  • CONCLUSIONS: In pulmonary cryptococcosis patients, the presence of fever, interstitial abnormalities on CXR or pleural effusion should lead clinicians to suspect disseminated infection.[ncbi.nlm.nih.gov]
Malaise
  • 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.[ncbi.nlm.nih.gov]
  • Immunosuppressed patients may present with mild-to-moderate symptoms, including fever, malaise, dry cough, chest pain. Severe infection may lead to pneumonia or adult respiratory distress syndrome.[dermnetnz.org]
  • Patients with cryptococcal pneumonia often experience cough, chest pains, low-grade fever, malaise, and shortness of breath.[verywell.com]
  • Central nervous system involvement is the most common manifestation of disseminated disease. [6] Common presenting features include a headache, fever, and malaise. Our case is also presented with similar clinical features.[jmedscindmc.com]
  • PC can cause vague symptoms such as fever, malaise, weight loss, dyspnea, or cough, or can be asymptomatic. Fever was much more common in immunocompromised patients than in immunocompetent patients (P 0.019).[jtd.amegroups.com]
Anorexia
  • 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.[ncbi.nlm.nih.gov]
Leg Edema
  • He was admitted to our hospital on November 22 following the appearance of bilateral leg edema in October 2000. Laboratory tests at presentation revealed nephrotic syndrome with renal impairment.[ncbi.nlm.nih.gov]
Cough
  • An 81-year-old man being treated with weekly low dose methotrexate (MTX) for psoriasis was admitted with a 2-month history of cough, shortness of breath and 7% eosinophilia in the peripheral blood.[ncbi.nlm.nih.gov]
Pulmonary Disorder
  • Morris Lippincott Williams & Wilkins, 2005 - Medical - 647 pages The thoroughly revised, updated Sixth Edition of this Spiral Manual is a complete, convenient, practical guide to diagnosis and management of pulmonary disorders.[books.google.com]
  • Clinical disease of the lungs by Cryptococcus spp was reported in pulmonary disorders like tuberculosis of lungs, pneumothorax and allergic bronchopulmonary Aspergillosis.[omicsonline.org]
Rales
  • In some cases, there may also be weight loss, swollen lymph glands ( lymphadenopathy ), rapid breathing ( tachypnea ), and audible crackles in the lung (rales).[verywell.com]
  • Physical examination may reveal lymphadenopathy, tachypnea, or rales.[hivinsite.ucsf.edu]
Dry Cough
  • Immunosuppressed patients may present with mild-to-moderate symptoms, including fever, malaise, dry cough, chest pain. Severe infection may lead to pneumonia or adult respiratory distress syndrome.[dermnetnz.org]
  • The patient had felt well until two weeks before her admission, when she began to experience a dry cough, dyspnea and pleuritic pain.[kjim.org]
Sputum Production
  • The majority of patients with pulmonary cryptococcosis are asymptomatic or simply report cough, scant sputum production, fever, dyspnoea and chest pain ,,, indistinguishable from other causes of pneumonia (reviewed in Chang et al. ).[hivmanagement.ashm.org.au]
Abdominal Distension
  • A male patient with no clinical evidence of immunodeficiency presented with a 3-week history of abdominal distension accompanied by oedema of recurring lower extremities.[ncbi.nlm.nih.gov]

Workup

  • A patient underwent resection of a superior sulcus tumor after an extensive workup was nondiagnostic. Postoperatively, primary pulmonary cryptococcosis was diagnosed. Management of this patient is presented along with a review of the literature.[ncbi.nlm.nih.gov]
  • There is insufficient data to support definitive conclusions from CrAg tests that become negative and subsequently become positive again; however, as such a result may be consistent with recurrence, a diagnostic workup for recurrent disease would seem[hivinsite.ucsf.edu]
Pulmonary Infiltrate
  • Persons with Cushing's syndrome and a pulmonary infiltrate should be examined for infection with Cryptococcus neoformans in addition to an examination for ectopic adrenocorticotropic hormone production.[ncbi.nlm.nih.gov]
  • Three subjects with underlying diseases (AIDS) were misdiagnosed with viral infection or Pneumocystis carinii infection, because the bilateral lung lesions involved diffuse pulmonary infiltrates, and a 2-week ganciclovir or caspofungin therapy was not[elynsgroup.com]
Atelectasis
  • 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.[ncbi.nlm.nih.gov]
Cryptococcus Antigen
  • Furthermore, the serum cryptococcus antigen was negative. Therefore, thoracoscopic partial lung resection was performed.[ncbi.nlm.nih.gov]

Treatment

  • Patients whose pulmonary nodules improved after treatment continued to experience gradual reduction of cryptococcosis antigen titers, even if antigen titers were positive at the time of treatment cessation.[ncbi.nlm.nih.gov]

Prognosis

  • OBJECTIVE: To investigate the clinical features, management, and prognosis of pulmonary cryptococcosis in non-acquired immunodeficiency syndrome (AIDS) patients.[ncbi.nlm.nih.gov]

Etiology

  • Fungal infections should be excluded in the presence of lung nodules and etiological identification is required for proper treatment.[ncbi.nlm.nih.gov]
  • Etiology of diffuse pneumonic infiltrates was undefined in 1 case due to lack of follow-up chest CT scan. Fig 3. A representative case of clinical deduction of pulmonary cryptococcosis.[journals.plos.org]
  • […] and Discontinuation 339 Oxygen Therapy and Toxicity 345 ProtocolDriven Care in Respiratory Therapy 351 Epidemiology Natural History 357 Prophylaxis 364 Chronic Thromboembolic Pulmonary Hypertension 375 Unusual Forms of Embolism 384 Pathogenesis and Etiology[books.google.com]
  • The ingestion of contaminated water acute self-limited diarrhea; chronic diarrhea, and other noninfectious etiologies should be excluded. These wounds appear grey clomid fedex or charred.[miketnelson.com]

Epidemiology

  • The main purpose of this review is to describe the epidemiology, clinical presentation, diagnosis, and treatment of pulmonary cryptococcosis to increase clinician's awareness of this diagnostic possibility and to enhance clinical management.[ncbi.nlm.nih.gov]
  • Rozenbaum R, Goncalves AJ: Clinical epidemiological study of 171 cases of Cryptococcosis . Clin Infect Dis 1994, 18: 369–380. PubMed Google Scholar 18.[link.springer.com]
  • The aim of our study was to clarify the epidemiological, clinical, radiological characteristics, as well as treatments of PC in these two groups of patients in southern China.[jtd.amegroups.com]
  • Epidemiology of Cryptococcal infections is unclear in India, where an increase in incidence of cryptococcosis was observed in AIDS patients in a study from north India (1992-2004).[omicsonline.org]
Sex distribution
Age distribution

Pathophysiology

  • Knowledge of the pathophysiology, epidemiology, clinical presentation, and treatment of pulmonary cryptococcosis may lead to greater recognition of this underdiagnosed IFI and improved outcomes. Thieme Medical Publishers.[ncbi.nlm.nih.gov]
  • These pathophysiologic considerations yielded important insights into several radiographic patterns in our study.[jtd.amegroups.com]

Prevention

  • Pulmonary cryptococcosis is common in non-AIDS patients and it warrants rapid diagnosis, treatment and follow-up to prevent relapse.[ncbi.nlm.nih.gov]
  • If the CD4 falls below 100, therapy should be restarted to prevent recurrence of disease.[verywell.com]
  • Prevention of bacterial endocarditis. ‎ Page 303 - American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. ‎[books.google.com]
  • Prophylaxis should be restarted if the CD4 count declines to Preventive Therapy Fluconazole is highly effective in preventing cryptococcal infection in advanced HIV disease.[hivinsite.ucsf.edu]

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