[A case of primary pulmonary cryptococcosis associated with pneumothorax]

We report a case of primary pulmonary cryptococcosis. A 20-year-old woman was admitted to the hospital complaining of coughing, fever, and dyspnea on exertion. She had no underling disease or immunological abnormality. Chest X-ray film revealed bilateral diffuse infiltrative shadows, which were first believed to have been caused by a community-acquired pneumonia. Pulmonary cryptococcosis was diagnosed from the results of a transbronchial lung biopsy. After 2.5 years of anti-mycotic chemotherapy with amphotericin B and flucytosine, pneumothorax occurred in the left lung. Thoracotomy and open lung biopsy were done. Histological findings of the open lung biopsy specimens showed numerous broken cryptococcal organisms within alveolar macrophages. Diffuse fibrosis accompanied by multiple bullae may have punctured bullae or blebs and thus led to pneumothorax.