Pulmonary cryptococcosis in chronic lymphocytic leukemia

Area of Science:

• Mycology
• Infectious Diseases
• Pulmonology

Background:

• Chronic lymphocytic leukemia (CLL) is an immunodeficiency disorder.
• Cryptococcus neoformans is an opportunistic fungal pathogen.
• Pulmonary cryptococcosis can be a severe infection in immunocompromised individuals.

Observation:

• A patient with CLL presented with extensive pneumonia.
• Wright's stain of sputum revealed Cryptococcus neoformans.
• High fungal loads (up to 8 x 10(5)/ml) were cultured from sputum.
• Fungal elements persisted morphologically for three weeks post-culture negativity.

Findings:

• Cryptococcus neoformans was identified in sputum and on cough plates.
• No other sources of C. neoformans were found in the patient's room.
• The patient received appropriate antifungal therapy.

Implications:

• This case highlights the potential for airborne transmission of Cryptococcus neoformans.
• Droplet transmission may occur from patients with extensive pulmonary cryptococcosis.
• Infection control measures should consider airborne precautions for such patients.