Recurrent pulmonary cryptococcosis during chronic HBV infection

Abstract

Rationale: Pulmonary cryptococcosis is one of the important opportunistic infections and has a wide range of symptoms depending on the underlying conditions. Here, we reported a case living with chronic hepatitis B virus infection who had a recurrent pulmonary cryptococcosis. Patient concerns: A 51-year-old male patient was admitted to our center because of cough, fatigue, and shortness of breath for 2 weeks. Diagnosis: Pulmonary infection was suggested by chest computed tomography. Most lab examinations for infection were negative and only cryptococcal antigen testing was positive. Therefore, a clinical diagnosis of pulmonary cryptococcosis was made. Interventions: Fluconazole (200 mg/day) and bicyclol (50 mg/day) was given orally. Outcomes: During the follow-up of 3 and 6 months, his conditions improved, and he recovered fully. Moreover, cryptococcal antigen level was 12.57 ng/mL. During the 2-year follow-up, no recurrence occurred. Lessons: This case highlights the importance of the awareness of opportunistic infections during chronic hepatitis B virus infection, especially the potential of recurrence.

Cryptococcal myositis and monoarthritis in a failed renal allograft recipient

“…Chronic HBV may alter immune response impairing phagocytic function, which may make transplant recipients susceptible to opportunistic infections like cryptococci. 3 The use of tacrolimus especially in the setting of renal failure predisposes to more osteoarticular and muscle involvement, compared to the CNS. 4 To our knowledge, the combined occurrence of cryptococcal myositis with monoarthritis has not been reported in renal transplant recipients, and this entity is restricted to a handful of case reports in the medical literature in association with conditions like B cell lymphoma 5 and diabetes mellitus.…”

“…The presence of PTDM and chronic HBV infection may have predisposed to cryptococcal infection in our patient. Chronic HBV may alter immune response impairing phagocytic function, which may make transplant recipients susceptible to opportunistic infections like cryptococci 3 . The use of tacrolimus especially in the setting of renal failure predisposes to more osteoarticular and muscle involvement, compared to the CNS 4 …”