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Updated: Jun 16, 2026
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Microbiological Rapid On-Site Evaluation for Pulmonary Infectious Diseases
Published on: March 1, 2024
Isolated pulmonary Cryptococcus neoformans infection presenting with severe pulmonary involvement: a case report
Boon Hau Ng1, Hsueh Jing Low2, Nik Nuratiqah Nik Abeed3
1Respiratory Unit, Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia. ngboonhau@hotmail.com.
Journal of Medical Case Reports
|June 14, 2026
Summary
Pulmonary cryptococcosis, a fungal infection, can mimic bacterial pneumonia in mildly immunocompromised patients. Early diagnosis and antifungal treatment are crucial for effective management and improved outcomes.
Area of Science:
- Pulmonology
- Infectious Diseases
- Mycology
Background:
- Pulmonary cryptococcosis is an uncommon fungal infection.
- It typically affects immunocompromised individuals.
- In mild immunosuppression, it can mimic bacterial pneumonia, causing diagnostic delays.
Purpose of the Study:
- To report a case of pulmonary cryptococcosis in a patient with mild immunosuppression.
- To highlight diagnostic challenges and treatment strategies.
Main Methods:
- Case report of a 50-year-old man with diabetes mellitus and myasthenia gravis on corticosteroids.
- Presented with fever, cough, and hypoxemic respiratory failure.
- Diagnosed via bronchoalveolar lavage (BAL) culture for Cryptococcus neoformans; treated with antifungals.
Main Results:
- Initial presentation suggested severe community-acquired pneumonia, unresponsive to antibiotics.
- Chest CT showed bilateral consolidations.
- Patient improved with amphotericin B (switched to flucytosine and fluconazole due to kidney injury), showing near-complete resolution at 6 months.
Conclusions:
- Pulmonary cryptococcosis can be misdiagnosed as community-acquired pneumonia.
- High suspicion is needed in patients with prolonged corticosteroid use, diabetes, and poor antibiotic response.
- Early recognition and prompt antifungal therapy improve patient outcomes.
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