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[Pulmonary cryptococcosis exhibiting diffuse multiple nodular shadows].

N Inui1, K Chida, T Suda

  • 1Department of Internal Medicine, Hamamatsu University School of Medicine, Japan.

Nihon Kokyuki Gakkai Zasshi = the Journal of the Japanese Respiratory Society
|March 5, 1999
PubMed
Summary
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Pulmonary cryptococcosis can present with unusual diffuse lung nodules, especially after measles infection. This case highlights a rare presentation in an immunocompetent patient due to temporary immune suppression.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Radiology

Background:

  • Pulmonary cryptococcosis typically presents as a solitary nodule or infiltrate.
  • Multiple nodular opacities are more common in immunocompromised individuals.
  • Measles infection is known to cause temporary immune suppression.

Observation:

  • A 39-year-old immunocompetent woman presented with cough and sputum.
  • Chest X-rays revealed diffuse nodular opacities mimicking metastatic lung cancer.
  • Transbronchial biopsies were inconclusive; thoracoscopic biopsy confirmed pulmonary cryptococcosis.

Findings:

  • The patient's diffuse nodular lung shadows were atypical for primary pulmonary cryptococcosis.
  • A preceding measles infection likely caused transient immunodeficiency.

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  • This secondary immunodeficiency explained the unusual presentation of pulmonary cryptococcosis.

    • Implications:

    • This case expands the differential diagnosis for diffuse pulmonary nodular opacities.
    • It underscores the importance of considering opportunistic infections in patients with recent viral illnesses.
    • Recognizing atypical presentations of pulmonary cryptococcosis is crucial for timely diagnosis and treatment.