[Primary pulmonary cryptococcosis treated with transbronchial injection of amphotericin B]

A 76-year-old man was admitted because of multiple nodular opacities in both lungs on chest X-ray. Cryptococcus was identified in the specimens obtained from bronchial brushing and bronchial washing. Primary pulmonary cryptococcosis was diagnosed as he had no underlying diseases and no foci in any other organs except the lung. Transbronchial injection (TBI) of amphotericin B was administered to the largest focus, in addition to the intravenous administration of miconazole. The chest tomogram 25 days after the first TBI showed marked decrease in the size of the largest focus, but no improvements were observed in other foci. TBI can be performed easily and safely, and perhaps more effectively than administration of amphotericin B with aerosol. This procedure may be of value in the treatment of pulmonary cryptococcosis.