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Disseminated cryptococcosis presenting as lung mass.

Manish Shankar¹, Satyadeo Choubey², Arshad Ejazi¹

¹Pulmonary Medicine, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.

BMJ Case Reports

|October 14, 2025

Summary

This case report details a disseminated cryptococcosis infection in an immunocompromised man with diabetes presenting with a pulmonary mass. Early diagnosis and treatment led to significant clinical improvement, emphasizing non-malignant considerations.

Keywords:

Cryptococcosis Pneumonia (respiratory medicine)

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Area of Science:

Mycology
Infectious Diseases
Pulmonology

Background:

Cryptococcosis is an opportunistic fungal infection primarily affecting immunocompromised individuals.
It can manifest with a wide range of symptoms, from asymptomatic pulmonary disease to life-threatening meningoencephalitis.

Purpose of the Study:

To report a case of disseminated cryptococcosis presenting as a pulmonary mass in an adult male with diabetes.
To emphasize the importance of considering non-malignant etiologies, such as fungal infections, in the differential diagnosis of pulmonary masses.

Main Methods:

A case report of a male patient in his late 40s with diabetes presenting with chest pain and weakness.
Diagnostic workup included contrast-enhanced CT of the chest, ultrasound-guided biopsy, cerebrospinal fluid analysis, and blood tests.
Treatment involved liposomal amphotericin B and oral fluconazole.

Main Results:

Contrast-enhanced CT revealed a left upper lobe mass.
Biopsy confirmed cryptococcosis; cryptococcal antigens were detected in cerebrospinal fluid and blood.
The patient demonstrated clinical and radiological improvement following treatment.

Conclusions:

Pulmonary masses in immunocompromised individuals are not always malignant.
Cryptococcosis should be considered in the differential diagnosis of pulmonary lesions, especially in patients with risk factors like diabetes and immunosuppression.
Prompt diagnosis and appropriate antifungal therapy are crucial for favorable outcomes in disseminated cryptococcosis.