[Retrospective analysis of seven cases of pulmonary cryptococcosis]

To understand the diagnosis and treatment of pulmonary cryptococcosis.

Patients diagnosed as having pulmonary cryptococcosis in the past 15 years were retrospectively studied. Their demographic data, respiratory symptoms, diagnostic methods, chest radiograph, immune state, antifungal therapy and follow-up results were analyzed.

Thirty cases of cryptococcosis were diagnosed, of which 7 were diagnosed as having pulmonary cryptococcosis, one of them presented with concomitant meningitis. Of the 7 patients, 4 were male and 3 were female, with a median age of 41.8. All were HIV negative; one case was immunocompromised with a history of colon cancer and glucocorticoid therapy for 8 months, while others were immunocompetent. Three patients complained of low fever or cough and sputum, while 4 others presented no symptoms. The X-ray and chest CT showed unilateral or bilateral patches, nodules or cavities. The diagnosis was made by pathology and bacterial culture of sputum or bronchoalveolar lavage fluid. Amphotericin B plus flucytosine were initially given to 4 patients, all of them developed liver and renal abnormalities to some degree after therapy. Three patients were given fluconazole or itraconazole initially. All the 7 patients with pulmonary cryptococcosis responded favorably to antifungal therapy and the prognosis was good.

Clinically pulmonary cryptococcosis was less common than cryptococcal meningitis. Pathology and cryptococcal culture were essential to the diagnosis. For immunocompetent patients with pulmonary cryptococcosis, the prognosis was good.