Pleural effusion in an immunocompetent host with cryptococcal pneumonia: A case report

Area of Science:

• Pulmonology
• Infectious Diseases
• Radiology

Background:

• Pulmonary cryptococcosis is an opportunistic fungal infection.
• It typically affects immunocompromised patients but can occur in immunocompetent hosts.
• Imaging findings in immunocompetent hosts differ from those in immunosuppressed patients.

Observation:

• A 29-year-old immunocompetent male presented with persistent cough and fever.
• Initial chest CT showed consolidation, misdiagnosed as pneumonia.
• Subsequent CT revealed cavities and pleural effusion, prompting further investigation.

Findings:

• Bronchoalveolar lavage and serum cryptococcal antigen tests were positive.
• Microscopy confirmed Cryptococcus capsules, and biopsy showed granulomatous inflammation.
• Histopathology confirmed pulmonary cryptococcosis.

Implications:

• This case demonstrates that cavities and pleural effusion can occur in immunocompetent hosts with pulmonary cryptococcosis.
• Clinicians should consider this diagnosis in immunocompetent patients presenting with atypical pulmonary findings.
• Prompt and appropriate antifungal treatment, such as voriconazole, is crucial for favorable outcomes.