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Cryptococcus gattii Infection Presenting as an Aggressive Lung Mass

Shuwei Zheng1, Thuan Tong Tan2, Jaime Mei Fong Chien2

  • 1Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore. shuwei.zheng@mohh.com.sg.

Mycopathologia
|December 8, 2017
PubMed

Insights

Cryptococcus gattii pneumonia rapidly progressed in an immunocompromised patient with human immunodeficiency virus (HIV). This case highlights varied fungal morphologies in bronchoalveolar lavage (BAL) specimens.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Pulmonology

Background:

  • Cryptococcus gattii is an endemic fungus in tropical/subtropical regions.
  • It primarily causes pulmonary disease with a tendency to affect the central nervous system.
  • Human immunodeficiency virus (HIV) infection can predispose individuals to opportunistic infections.

Observation:

  • A 51-year-old Chinese male with HIV presented with declining function and a left hilar mass.
  • Chest imaging revealed consolidation and rapid lesion expansion over 10 days.
  • Bronchoalveolar lavage (BAL) cytology showed yeasts of diverse sizes.

Findings:

  • The BAL fluid culture confirmed the presence of Cryptococcus gattii.
  • The patient had a rapidly progressing C. gattii pneumonia despite virological suppression.
  • The case demonstrated varied fungal morphologies in cytological specimens.

Implications:

  • This case underscores the importance of considering C. gattii in immunocompromised patients, even with HIV viral suppression.
  • Recognizing diverse fungal morphologies in BAL is crucial for early diagnosis.
  • Prompt identification and treatment are vital for managing C. gattii pneumonia in at-risk populations.
Keywords:
Aggressive lung massCryptococcosisCryptococcus gattii pneumoniaHuman immunodeficiency virus infectionRapidly enlarging lung mass

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