Pulmonary cryptococcosis in immunocompetent patients

Murayama, Sadayuki; Sakai, Shuji; Soeda, Hiroyasu; Yabuuchi, Hidetake; Masuda, Kouji; Inoue, Hiromasa; Watanabe, Hideyuki; Matsuo, Yoshitomo

doi:10.1016/s0899-7071(03)00145-1

Cited by 47 publications

(41 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Surrounding groundglass opacity or the CT halo sign, as found in our study, and isolated groundglass opacity (6,(8)(9)(10)(11)17) can be observed. Although centrilobular or satellite nodules have been described (6,8), tree-inbud appearance was observed neither in the present nor in previous studies (6)(7)(8)(9). Therefore, we suggest that the presence of nonenhanced low-attenuation areas within the areas of consolidation or mass having peripheral, subpleural and lower lung predominance, as shown in the present study, should raise the concern for pulmonary cryptococcosis, particularly in a patient presenting with meningitis.…”

Section: Discussioncontrasting

confidence: 91%

“…As with previous studies, pleural effusion is also uncommon, found in less than 10% of cases, and is often small in size (3)(4)(5)(6)(7)(8)(9)(10)18).…”

Section: Discussionsupporting

confidence: 72%

“…Cavitation and air-filled bronchograms within nodules or consolidation, observed in 58.3% of our cases, have been variably demonstrated in previous studies, ranging from 0% to 42% of cases (4)(5)(6)(7)(8)(9)(10)(11)15). Nonenhanced, low-attenuation areas within the areas of consolidation or masses, previously shown to represent gelatinous collections of large numbers of fungal organisms or rarely ischemic necrosis (12,15,16) were also frequently demonstrated on CT images in our study but have rarely been described (17).…”

Section: Discussionsupporting

confidence: 60%

“…In rare circumstances, the infection occurs in otherwise healthy individuals. According to previous studies from many countries in North America, Europe, and the East (3)(4)(5)(6)(7)(8)(9)(10)(11), most immunocompetent individuals have mild or no clinical symptoms with isolated pulmonary involvement through single or multiple small pulmonary nodules. These findings are somewhat different from the more aggressive clinical and radiographic findings described in isolated case reports among Thai immunocompetent patients (6,(12)(13)(14) and in a study from South America (3).…”

Section: P Ulmonary Cryptococcosis Is An Emerging Infection Caused Bymentioning

confidence: 99%

See 3 more Smart Citations

Clinical and radiologic manifestations of pulmonary cryptococcosis in immunocompetent patients and their outcomes after treatment

Suwatanapongched

Sangsatra²,

Boonsarngsuk³

et al. 2013

Diagn Interv Radiol

View full text Add to dashboard Cite

ORIGINAL ARTICLE PURPOSE We aimed to investigate clinical and radiologic manifestations of pulmonary cryptococcosis in immunocompetent patients and their outcomes after treatment. MATERIALS AND METHODSWe retrospectively reviewed the medical records, initial and follow-up chest computed tomography scans and/or radiographs for initial clinical and radiologic manifestations and outcomes following antifungal treatment of 12 immunocompetent patients diagnosed with pulmonary cryptococcosis between 1990 and 2012. RESULTSTwelve patients (age range, 21-62 years; males, eight patients [66.7%]) were included. Nine (75%) patients were symptomatic, eight of whom had disseminated infection with central nervous system involvement. Initial pulmonary abnormalities consisted of single nodules/masses (n=5), single segmental or lobar mass-like consolidation (n=3), multiple cavitary and noncavitary nodules (n=1), and multifocal consolidation plus nodules (n=3). These lesions ranged from less than 1 cm to 15 cm in greatest diameter. Distinct subpleural and lower lung predominance was observed. Seven patients (58.3%) had one or more atypical/aggressive findings, namely endobronchial obstruction (n=4), calcified (n=1) or enlarged (n=4) mediastinal/hilar lymph nodes, vascular compression (n=1), pericardial involvement (n=1), and pleural involvement (n=2). Following antifungal therapy, radiologic resolution was variable within the first six months of eight nonsurgical cases. Substantial (>75%) improvement with some residual abnormalities, bronchiectasis, cavitation, and/or fibrotic changes were frequently observed after 12-24 months of treatment (n=6). CONCLUSIONPulmonary cryptococcosis in immunocompetent patients frequently causes disseminated infection with atypical/aggressive radiologic findings that are gradually and/or incompletely resolved after treatment. The presence of nonenhanced low-attenuation areas within subpleural consolidation or mass and the absence of tree-in-bud appearance should raise concern for pulmonary cryptococcosis, particularly in patients presenting with meningitis.

show abstract

Section: Discussioncontrasting

confidence: 91%

“…As with previous studies, pleural effusion is also uncommon, found in less than 10% of cases, and is often small in size (3)(4)(5)(6)(7)(8)(9)(10)18).…”

Section: Discussionsupporting

confidence: 72%

Section: Discussionsupporting

confidence: 60%

Section: P Ulmonary Cryptococcosis Is An Emerging Infection Caused Bymentioning

confidence: 99%

See 2 more Smart Citations

Clinical and radiologic manifestations of pulmonary cryptococcosis in immunocompetent patients and their outcomes after treatment

Suwatanapongched

Sangsatra²,

Boonsarngsuk³

et al. 2013

Diagn Interv Radiol

View full text Add to dashboard Cite

show abstract

“…Computed tomography similarly reveals one or more pulmonary nodules and/or areas of consolidation. Cavitation may occur within nodules or areas of infiltrate and has been noted in 14 to 21% of plain chest radiographs and 10 to 42% of computed tomography scans of immunocompetent patients with cryptococcal infection (52,114,187,218,271,276,403). Immunocompromised patients with pulmonary cryptococcal infection will also commonly have consolidation, hilar lymphadenopathy, and multiple pulmonary nodules, while solitary pulmonary nodules are less often encountered (187,249,384).…”

Section: Histoplasmosis the Dimorphic Fungusmentioning

confidence: 99%

Cavitary Pulmonary Disease

2008

View full text Add to dashboard Cite

SUMMARY A pulmonary cavity is a gas-filled area of the lung in the center of a nodule or area of consolidation and may be clinically observed by use of plain chest radiography or computed tomography. Cavities are present in a wide variety of infectious and noninfectious processes. This review discusses the differential diagnosis of pathological processes associated with lung cavities, focusing on infections associated with lung cavities. The goal is to provide the clinician and clinical microbiologist with an overview of the diseases most commonly associated with lung cavities, with attention to the epidemiology and clinical characteristics of the host.

show abstract

Steroid resistance in organizing pneumonia caused by pulmonary cryptococcosis

Nomura

Ohta

Hiruta

et al. 2020

Respirology Case Reports

View full text Add to dashboard Cite

Cryptogenic organizing pneumonia (COP) usually responds well to steroid therapy; however, recurrence is commonly observed when the steroid dose is tapered. A 74-year-old man suspected of having steroid-resistant COP presented to our hospital. Chest computed tomography (CT) revealed new consolidations of the left inferior lobe despite administration of a moderate dose of oral steroids. Repeated transbronchial lung biopsy showed pulmonary cryptococcosis. The left interior consolidations shrank gradually after antifungal therapy was initiated. Immunocompromised patients with pulmonary cryptococcosis show various CT findings, and consolidation is frequently observed. Superimposed pulmonary cryptococcosis infection should be considered in cases of steroid-refractory COP.

show abstract

Pulmonary cryptococcosis in immunocompetent patients

Cited by 47 publications

References 13 publications

Clinical and radiologic manifestations of pulmonary cryptococcosis in immunocompetent patients and their outcomes after treatment

Clinical and radiologic manifestations of pulmonary cryptococcosis in immunocompetent patients and their outcomes after treatment

Cavitary Pulmonary Disease

Steroid resistance in organizing pneumonia caused by pulmonary cryptococcosis

Contact Info

Product

Resources

About