Pulmonary Cryptococcosis Infection in Non-HIV Patients in a Tertiary Care Center in Taiwan

Pulmonary cryptococcosis is an important opportunistic fungal infection in immunocompromised individuals, including those with an infection of the human immunodeficiency virus (HIV) but it can be increasingly seen in non-HIV patients.

We retrospectively reviewed the medical records of 58 non-HIV-infected patients with International Classification of Diseases, Ninth Revision, Clinical Modification Code B45.0 (pulmonary cryptococcosis) who were admitted to the Chi-Mei Hospital, Taiwan from January 2016 to April 2022.

Of the enrolled 58 cases, 56 patients had no evidence of disease outside the lungs, and only two patients (3.4%) had disseminated diseases. Thirty-nine patients had pathologically confirmed pulmonary cryptococcosis, and 19 patients had clinically confirmed disease. Pulmonary cryptococcus patients with cancer had a nonsignificant numerically higher rate of ICU use (14.29% vs. 5.13%; p = 0.348). There were similar mortality rates in both cancer and noncancer patients with pulmonary cryptococcosis (4.76% vs. 2.70%; p = 0.581). Patients in the cancer and noncancer groups had a similar duration of hospital stay (7 vs. 6 days, p = 0.799) and low mortality rates (4.76% vs. 2.70%, p = 0.581) on standard antifungal therapy.

Cancer and noncancer patients had similar good outcomes after receiving appropriate standard antifungal treatment. Asymptomatic patients with pulmonary cryptococcosis diagnosed incidentally are self-limited and require no antifungal therapy.

IRB number: 11111-004.