Pulmonary cryptococcosis in non-AIDS patients

Abstract

PURPOSE: To clarify the clinical features and imaging characteristics of non-AIDS patients with pulmonary cryptococcosis. METHODS: We retrospectively collected 15 HIV-negative patients with pathology-proved pulmonary cryptococcosis from Sep 1992 to Jan 2008. Their medical records and radiological data were reviewed and analyzed. RESULTS: Only one patient was asymptomatic.Thirteen patients were immunocompetent and two were immunosuppressed. Three patients had associated cryptococcosis meningitis. The most common radiographic abnormalities were multiple pulmonary nodules or masses, seen in 8 and 5 cases of patients respectively. 14 patients received specific therapy for Cryptococcus neoformans. Two patients died. In the 11 patients with isolated pulmonary cryptococcosis, treatment consisted of fluconazole alone (n=7), in combination with amphotericin B (n=2), and both 5-flucytosine and amphotericin B (n=2). For the other 2 patients with cryptococcosis meningitis, one was treated with amphotericin B alone and the other with fluconazole combined with amphotericin B and 5-flucytosine. CONCLUSIONS: Non-AIDS patients might also susceptible to cryptococcosis infection. Histological examination is the principal method of diagnosis. The most common CT findings are solitary or multiple nodules with or without cavitation in the subpleural areas of the lung.