Cavitary cryptococcoma of the lungs and meningitis by Cryptococcus neoformans in a patient with AIDS

We report on a 39-year-old AIDS patient who presented a generalized cryptococcal disease with involvement of the lungs and central nervous system. Although the initial symptoms were mild and uncharacteristic, the radiological finding of cavernous destructions of the lungs (cryptococcoma) was detectable. The patient recovered after an initial 3 week therapy with amphotericin B and fluconazole followed by secondary prevention with fluconacole. The cavernous destructions receded within 4 months. Though the respiratory tract is the presumed port of entry for Cryptococcus neoformans, a cavernous destruction of pulmonary tissue without a diffuse infiltration of the lungs is a rare manifestation of cryptococcosis even in HIV patients.