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Cryptococcal empyema: case report and review

V E Mulanovich1, W E Dismukes, N Markowitz

  • 1Division of Infectious Diseases, University of Alabama at Birmingham, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 1, 1995
PubMed
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Cryptococcus neoformans can cause pleural empyema in individuals with human immunodeficiency virus (HIV). Prompt diagnosis with a pleural fluid cryptococcal antigen test and treatment with antifungal therapy can lead to successful outcomes.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Mycology

Background:

  • Pleural effusions are common in patients with human immunodeficiency virus (HIV).
  • Cryptococcal infections typically manifest in the central nervous system or lungs but can affect other sites.
  • Pleural empyema is a rare but serious complication.

Observation:

  • A 28-year-old HIV-infected male presented with cryptococcal pleural empyema.
  • The patient was successfully treated with chest-tube drainage and antifungal therapy, including 1 year of fluconazole maintenance.
  • No relapse occurred during the follow-up period.

Findings:

  • A review of English-language literature identified only three previously reported cases of cryptococcal empyema, one in an HIV-infected patient.

Related Experiment Videos

  • A pleural fluid cryptococcal antigen test was diagnostic in this case.
  • This diagnostic test should be considered for unexplained pleural empyema in immunocompromised individuals.

    • Implications:

    • Early diagnosis of cryptococcal pleural empyema is crucial for effective management.
    • The pleural fluid cryptococcal antigen test is a valuable diagnostic tool.
    • Aggressive antifungal treatment and maintenance therapy can prevent relapse in HIV-infected patients with cryptococcal pleural empyema.