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[Primary pulmonary cryptococcosis with pleural effusion]

K Matsunaga1, Y Minakata, S Yukawa

  • 1Department of Respiratory Disease, Kokuho Naga Hospital, Wakayama, Japan.

Nihon Kokyuki Gakkai Zasshi = the Journal of the Japanese Respiratory Society
|December 9, 1998
PubMed
Summary
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A rare case of primary pulmonary cryptococcosis in an immunocompetent woman presented with chest pain and pleural effusion. The infection resolved spontaneously without antifungal treatment, highlighting unusual clinical and radiological features.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • Mycology

Background:

  • Primary pulmonary cryptococcosis is a fungal infection primarily affecting the lungs.
  • It is often seen in immunocompromised individuals, making cases in immunocompetent patients rare.

Observation:

  • A 32-year-old immunocompetent woman presented with acute left chest pain and radiographic evidence of nodular lung shadows and pleural effusion.
  • Transbronchial biopsy confirmed Cryptococcus fungal elements.
  • Blood and pleural fluid were cryptococcal antigen-positive, but cerebrospinal fluid was negative.

Findings:

  • The patient was diagnosed with primary pulmonary cryptococcosis.
  • Symptoms and radiographic findings improved spontaneously within 10 days.
  • Complete resolution occurred within 4.5 months without any antifungal therapy.

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Implications:

  • This case highlights the possibility of primary pulmonary cryptococcosis in immunocompetent individuals presenting with pleuropulmonary disease.
  • The presence of pleural effusion and pronounced inflammatory reactions can be key diagnostic clues.
  • Spontaneous resolution suggests a role for host immune response in managing pulmonary cryptococcosis.