[Primary pulmonary cryptococcosis with multiple infiltrative shadows complicated by obstructive sleep apnea syndrome]

In November 2007, a 30-year-old obese woman was admitted to our hospital with a complaint of persistent dry cough. Her chest-X-ray and computed tomography revealed multiple infiltrative shadows with air bronchograms in all lung fields. The bronchoalveolar lavage fluid revealed small bodies of Cryptococcus species. Cryptococcal serum antigen was also positive. To examine the cause of her snoring, polysomnography was done and revealed obstructive sleep apnea syndrome. The patient was given a diagnosis of primary pulmonary cryptococcosis with obstructive sleep apnea syndrome. After 12 months of treatment with fluconazole, the infiltrative shadows disappeared. Pulmonary cryptococcosis should be considered in the differential diagnosis of pulmonary multiple infiltrated shadows in patients without immunological abnormalities.