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Pulmonary Cryptococcosis
Cryptococcosis

Presentation

Pulmonary cryptococcosis presenting as an endobronchial tumour-like growth has rarely been described. We report the case of a male patient with normal immune function who presented with a right upper lobe mass lesion. [ncbi.nlm.nih.gov]

Entire Body System

  • 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]

    Other symptoms include fever, weight loss, malaise and coughing up blood or hemoptysis. On rare occasions, pleural effusion occurs. Severe pulmonary diseases and respiratory syndromes are more likely to occur in those with weakened immune systems. [news-medical.net]

    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]

  • Anemia

    CONCLUSION: If a patient with anemia and thrombocytopenia shows GGA or consolidation in the lung, pulmonary cryptococcosis should be given careful consideration. [ncbi.nlm.nih.gov]

    Axelrod Fatal aplastic anemia resulting from Flucytosine JAMA, 228 (1974), pp. 1573 [28.] C.S. Bryan, J.A. McFarland Cryptococeal meningitis Fatal marrow aplasia from combined therapy JAMA, 239 (1978), pp. 1068 [29.] G. Medoff, M. Comfort, G.S. [archbronconeumol.org]

    Only a small but significant anemia thrombocytopenia prolonged clotting time hypofibrinogenemia metabolic acidosis develop, this may be a history of trauma, an ophthalmologist is often helpful in distinguishing between upper and lower extremity in the [miketnelson.com]

  • Sepsis

    In children with sepsis, respiratory distress, failure, acidosis, carboxyhemoglobin, methemoglobin information about intracranial abnormalities on neurologic and vascular examination of children receive bystander cpr, and use of local anesthetic solution [miketnelson.com]

    Bassetti M,Repetto E,Mikulska M,Miglino M,Clavio M, et al. (2009) Cryptococcus neoformans fatal sepsis in a chronic lymphocytic leukemia patient treated with alemtuzumab: case report and review of the literature. J Chemother 21: 211-214. [omicsonline.org]

Respiratoric

  • 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]

  • Aspiration

    A simple diagnostic method, Riu's stain, can be used routinely in bronchoscopic brushing smears, or for needle aspiration cytologic studies, making pulmonary cryptococcosis easy to diagnose. [ncbi.nlm.nih.gov]

  • Dyspnea

    The major clinical manifestations were cough (47 pts, 62%), expectoration (29 pts, 38%), fever (16 pts, 21%), chest pain (15 pts, 20%), dyspnea (17 pts, 22%), and emaciation (10 pts, 13%). Eighteen patients (24%) were asymptomatic. [ncbi.nlm.nih.gov]

    In the minority of cases where symptoms do develop, signs may vary from a non-specific cough to more severe symptoms such as shortness of breath (dyspnea) or pleuritic chest pain. [news-medical.net]

  • 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]

Gastrointestinal

  • Abdominal Pain

    An 84-year-old Asian female presented to our hospital with complaints of a 1-week history of abdominal pain and appetite loss. Chest computed tomography (CT) showed diffuse micronodules in random patterns in both lung fields. [ncbi.nlm.nih.gov]

    Table 1 Side effects of antifungal agents used in Cryptococcosis Fluconazole Mild to moderate nausea, vomiting, abdominal pain, diarrhoea Rash – may be associated with eosinophilia and pruritus Stevens-Johnson syndrome – rare, but may be fatal Increased [hivmanagement.ashm.org.au]

Neurologic

  • Headache

    A 52-year-old immunocompetent Han Chinese woman was presented to our emergency department complaining of headache and vomiting accompanied by postural changes. [ncbi.nlm.nih.gov]

    The symptoms are often similar to those of many other illnesses, and can include: Headache, fever, and neck pain are common symptoms of cryptococcal meningitis. [cdc.gov]

    Any patients with HIV infection presenting with subacute/ chronic headache, particularly those who are CD4-deplete, should be investigated for CM. [hivmanagement.ashm.org.au]

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]

X-Ray

  • 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]

Microbiology

  • Cryptococcus Antigen

    However, tumor markers were elevated: serum carcinoembryonic antigen, 5.9 ng/mL; pro-gastrin-releasing peptide, 84.6 pg/mL. Furthermore, the serum cryptococcus antigen was negative. Therefore, thoracoscopic partial lung resection was performed. [ncbi.nlm.nih.gov]

Treatment

PURPOSE: We aimed to investigate clinical and radiologic manifestations of pulmonary cryptococcosis in immunocompetent patients and their outcomes after treatment. [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

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 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]

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]

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

[…] cytologic examination of deep cough samples of sputum in cases with an appropriate clinical setting and pulmonary infiltrates not only can be a rewarding procedure but also can result in the institution of an appropriate line of treatment for the possible prevention [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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