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Cryptococcal pleuritis containing a high level of adenosine deaminase in a patient with AIDS: a case report

Yusuke Yoshino1, Takatoshi Kitazawa, Keita Tatsuno

  • 1Department of Infectious Diseases, Graduate School of Medicine, University of Tokyo, Tokyo 113-8655, Japan.

Respiration; International Review of Thoracic Diseases
|May 2, 2009
PubMed

Insights

Cryptococcal pleuritis is a rare presentation of acquired immune deficiency syndrome (AIDS). High adenosine deaminase (ADA) levels in pleural fluid may indicate cryptococcal infection, necessitating longer incubation for diagnosis.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Immunocompromised Hosts

Background:

  • Cryptococcal infection is a leading opportunistic infection in patients with acquired immune deficiency syndrome (AIDS).
  • Pleural effusion is an uncommon manifestation of cryptococcal infection.
  • Distinguishing cryptococcal pleuritis from tuberculous pleuritis can be challenging.

Observation:

  • A case of cryptococcal pleuritis in an AIDS patient is presented.
  • The patient initially presented with pleural effusion.
  • Pleural fluid adenosine deaminase (ADA) levels were high, mimicking tuberculous pleuritis.

Findings:

  • Cryptococcus neoformans was identified in pleural fluid cultures after antituberculous treatment began.
  • High pleural fluid ADA levels can be associated with cryptococcal pleuritis.
  • Standard diagnostic procedures may not be sufficient for rapid identification.

Implications:

  • Clinicians should consider cryptococcal pleuritis in AIDS patients with unexplained pleural effusion and high ADA levels.
  • Extended incubation of pleural fluid cultures is crucial for diagnosing cryptococcal pleuritis.
  • This case highlights the importance of considering atypical presentations of opportunistic infections in immunocompromised individuals.

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