Pulmonary cryptococcal infection in an untreated patient with sarcoidosis

A 36-year-old housewife was referred to our hospital in March, 1993. Her chest X ray films showed mediastinal and bilateral hilar lymphadenopathy. She was confirmed to have pulmonary sarcoidosis. We did not administer any medications for her. Four months after the diagnosis of sarcoidosis, opacities with cavitation appeared on the chest X ray. Histologic findings of lung biopsy specimens revealed granulomas with the existence of encapsulated Cryptococci. We administered an antifungal drug, itraconazole. The opacities were greatly improved by the medication. We report focal pulmonary cryptococcal infection in an untreated patient with sarcoidosis.