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[Primary pulmonary cryptococcosis with endobronchial lesion]
1Second Department of Internal Medicine, Oita Medical University, Japan.
Summary
Pulmonary cryptococcosis in a young man was initially misdiagnosed as bacterial pneumonia. Fluconazole treatment effectively resolved the endobronchial lesion and lung nodules, confirming its therapeutic efficacy.
Area of Science:
- Pulmonology
- Infectious Diseases
- Mycology
Background:
- Pulmonary cryptococcosis is a fungal infection that can present with diverse radiologic findings.
- Endobronchial lesions are an uncommon manifestation of pulmonary cryptococcosis.
- Accurate diagnosis is crucial for appropriate treatment, especially in immunocompetent individuals.
Observation:
- A 19-year-old man presented with symptoms suggestive of bacterial pneumonia.
- Initial antibiotic treatment was ineffective, prompting further investigation.
- Bronchofibroscopy revealed an elevated lesion in the truncus intermedius.
Findings:
- Histopathology confirmed cryptococcal organisms and monocyte infiltration, diagnosing pulmonary cryptococcosis with an endobronchial lesion.
- Chest X-rays showed multiple nodular shadows that did not resolve with antibiotics.
- Treatment with fluconazole led to the complete resolution of nodular shadows.
Implications:
- This case highlights pulmonary cryptococcosis presenting as an endobronchial lesion.
- It underscores the importance of considering fungal infections in persistent pulmonary symptoms.
- Fluconazole demonstrated efficacy in treating this form of pulmonary cryptococcosis.