ABSTRACT
Pulmonary cryptococcosis is an unusual fungal infection that is most often found in AIDS or in organ transplant recipients. Although in immunocompromised patients, cryptococcal infection often causes pulmonary infections, the diagnosis of lung involvement is generally difficult. The presentation of pulmonary cryptoccosis in HIV-infected patients appears to be more acute and severe than in other immunocompromised patients, probably related with the severe immunosuppression. Diffuse infiltrates, mediastinal and hilar lymph nodes enlargement are the most common radiological findings in AIDS-associated pulmonary cryptococcosis. Cavitation is a rare form of and includes only 10% to 15% of all cases. Only a few case reports or studies with small number of patients of pulmonary cryptococcosis have been published over the past two decades. We report a case of an AIDS patient who developed cavitary pneumonia as the only clinical expression of cryptococcosis.
Subject(s)
AIDS-Related Opportunistic Infections/diagnostic imaging , Cryptococcosis/diagnostic imaging , Lung Diseases, Fungal/diagnostic imaging , AIDS-Related Opportunistic Infections/drug therapy , Adult , Antibiotic Prophylaxis , Antifungal Agents/therapeutic use , Antiretroviral Therapy, Highly Active , Cryptococcosis/diagnosis , Cryptococcosis/drug therapy , Diagnosis, Differential , Fluconazole/therapeutic use , Humans , Itraconazole/therapeutic use , Lung Diseases, Fungal/drug therapy , Male , Tomography, X-Ray Computed , Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic useABSTRACT
La criptococosis pulmonar es una infección fúngica poco frecuente, cuyohallazgo es más común en pacientes con sida o en los inmunodeprimidos portrasplantes. A pesar de que en estos pacientes las formas diseminadas de laenfermedad provocan con frecuencia síntomas respiratorios, el diagnóstico dela afectación pulmonar en la criptococosis es siempre dificultoso.La presentación clínica suele ser más aguda y grave en los pacientes VIHpositivos que en los portadores de otras inmunodeficiencias, probablementeen relación con el mayor grado de inmunodepresión. Los infiltrados difusos ylas adenomegalias hiliares y mediastinales son los hallazgos radiológicos máscomunes en la criptococosis pulmonar asociada con el sida. Las lesionescavitadas son una forma rara de presentación que incluye sólo del 10% al15% de todos los casos.Se presenta un paciente con sida que desarrolló una neumonía cavitada comoúnica manifestación clínica demostrable de la criptococosis(AU)
Pulmonary cryptococcosis is an unusual fungal infection that is most oftenfound in AIDS or in organ transplant recipients. Although inimmunocompromised patients, cryptococcal infection often causes pulmonaryinfections, the diagnosis of lung involvement is generally difficult. Thepresentation of pulmonary cryptoccosis in HIV-infected patients appears to bemore acute and severe than in other immunocompromised patients, probablyrelated with the severe immunosuppression. Diffuse infiltrates, mediastinal andhilar lymph nodes enlargement are the most common radiological findings inAIDS-associated pulmonary cryptococcosis. Cavitation is a rare form of andincludes only 10% to 15% of all cases. Only a few case reports or studieswith small number of patients of pulmonary cryptococcosis have beenpublished over the past two decades.We report a case of an AIDS patient who developed cavitary pneumonia asthe only clinical expression of cryptococcosis(AU)
