Criptococose pulmonar isolada em paciente imunocompetente

Barbosa, Ana Teresa Fernandes; Colares, Fernando Antônio; Gusmão, Edson da Silva; Barros, Amanda Araújo; Cordeiro, Cristiane Gonçalves; Andrade, Maria Cecília Tolentino

doi:10.1590/s1806-37132006000500016

Cited by 10 publications

(4 citation statements)

References 13 publications

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“…Immunocompetent individuals, such as the patient in question, present with nodular lesions or masses [1,4]. Other cases of immunocompetent patients reported in the literature showed the same image aspect, however, clinical history was variable [4,6,7]. This report reinforces the importance of pseudotumoral lesions for the differential diagnosis of lung masses by radiologists, pulmonologists and oncologists.…”

Section: Discussionsupporting

confidence: 60%

Pulmonary cryptococcosis in an immunocompetent patient—A case report

Morbeck¹,

Franco²,

Furlan³

et al. 2013

CRCM

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Cryptococcosis is an infection caused by fungi that belong to the genus Cryptococcus. There are several species of Cryptococcus, but two species-Cryptococcus neoformans and Cryptococcus gattii-cause nearly all cryptococcal infections in humans. Cryptococcosis is one of the most common fungal infections in Brazil and becomes even more important after the onset of the AIDS epidemic. The lung is the main gateway, and also is the most common site, with diverse clinical manifestations ranging from an asymptomatic to severe pneumonia. When symptommatic, most patients present with fever and cough with expectoration or hemoptysis. The most common radiological findings in immunocompetent patients are located images of masses and nodules, while immunosuppression shows interstitial infiltrates and diffuses interstitial opacity. This is a case report of a patient in the third decade of life with breathing-dependent pain at the base of the left hemithorax, who has radiological examination of a mass in the left lung base in contact with the pleura mimicking malignant lung. Lobectomy was performed, as well as the pathological diagnosis of cryptococcosis.

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Section: Discussionsupporting

confidence: 60%

Pulmonary cryptococcosis in an immunocompetent patient—A case report

Morbeck¹,

Franco²,

Furlan³

et al. 2013

CRCM

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“…Although already described, the lung masses are less common. 12 However, a Brazilian study showed that pulmonary masses were the most frequent finding (64.2%), followed by nodules (35.7%). 13 Pulmonary consolidation, pleural effusions, lymphadenopathy, or cavitation were rarely detected on radiography of immunocompetent patients.…”

Section: Discussionmentioning

confidence: 97%

Pulmonary Cryptococcoma: A Rare and Challenging Diagnosis in Immunocompetent Patients

Haddad¹,

Cavallaro²,

Lopes³

et al. 2015

ACR

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Cryptococcal infection is commonly seen in immunocompromised patients, although immunocompetent patients may also be infected. The pathogen’s portal of entry is the respiratory tract; however, the central nervous system is predominantly involved. Pulmonary involvement varies from interstitial and alveolar infiltrations to large masses, which are frequently first interpreted as lung neoplasm. The diagnosis of pulmonary cryptococcosis, in these cases, is frequently challenging, which, in most cases, requires histopathological examination.The authors report the case of a young female patient who presented a 20-day history of chest pleuritic pain and fever at the onset of symptoms. HIV serology was negative and CD4 count was normal. The imaging work-up was characterized by a huge opacity in the left inferior pulmonary lobe with a wide pleural base. Computed tomography showed a heterogeneous mass involving the bronchial tree. Mediastinal involvement was poor, and there was a splenomegaly. The patient underwent an exploratory thoracotomy and inferior lobectomy. The histopathological examination revealed a cryptococcoma. As the serum antigenemia was positive, the patient was scheduled for long-term treatment with fluconazole. The authors call attention to including the cryptococcal infection in the differential diagnosis of lung mass, mainly when localized in the lung bases in immunocompetent patients.

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“…The incidence of pulmonary cryptococcosis among patients with negative serology for HIV is low, around 0.2–0.9 per 100 000 inhabitants [ 2 ]. For this pathology to become established, it requires some degree of cellular immune deficiency, represented by changes in the in T-cells, natural killer cells, polymorphonuclear leukocytes, macrophages and specific antibodies [ 3 ].…”

Section: Discussionmentioning

confidence: 99%