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Updated: May 25, 2026
Microbiological Rapid On-Site Evaluation for Pulmonary Infectious Diseases
Published on: March 1, 2024
Retrospective analysis of 76 immunocompetent patients with primary pulmonary cryptococcosis
Feng Ye1, Jia-xing Xie, Qing-si Zeng
1Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, Guangzhou Medical University, 151 Yan Jiang Road, Guangzhou, People's Republic of China. fye111@126.com
Insights
Primary pulmonary cryptococcosis, a fungal lung infection, can affect healthy individuals. Early diagnosis via chest X-ray and treatment with antifungals like fluconazole lead to good outcomes.
Area of Science:
- Infectious Diseases
- Pulmonology
- Mycology
Background:
- Pulmonary cryptococcosis typically affects immunocompromised individuals.
- However, it can also manifest in immunocompetent patients.
- This study focuses on primary pulmonary cryptococcosis in immunocompetent hosts.
Purpose of the Study:
- To describe the clinical features, diagnostic approaches, and management strategies for primary pulmonary cryptococcosis in immunocompetent patients.
- To identify key characteristics aiding in the diagnosis and successful treatment of this condition.
Main Methods:
- Retrospective review of clinical data from 76 patients with primary pulmonary cryptococcosis.
- Data collected from 1995 to 2010.
- Histological confirmation of pulmonary cryptococcosis in all cases.
Main Results:
- The study included 76 patients, with a mean age of 42.5 years; 72% were male.
- Common symptoms included cough (62%), expectoration (38%), and fever (21%).
- Chest X-ray shadows were the predominant finding, with lesions often located in the lower lung (78.9%) and appearing as patchy consolidations (37%).
Conclusions:
- Primary pulmonary cryptococcosis in immunocompetent patients typically occurs in those under 50 without prior lung disease.
- Chest X-ray abnormalities are the main diagnostic clue.
- Complete courses of antifungal therapy, including fluconazole, result in favorable outcomes.
Background:
Pulmonary cryptococcosis typically occurs in immunocompromised patients, but it can also occur in immunocompetent patients. Our objective was to describe the clinical manifestations, diagnosis, and management of primary pulmonary cryptococcosis in immunocompetent patients.
Methods:
We retrospectively reviewed the clinical data of 76 patients with primary pulmonary cryptococcosis who were admitted to our hospital from 1995 to 2010.
Results:
Pulmonary cryptococcosis was pathologically proven in all patients. Mean patient age was 42.5 years and 55 patients (72%) were male. The major clinical manifestations were cough (47 pts, 62%), expectoration (29 pts, 38%), fever (16 pts, 21%), chest pain (15 pts, 20%), dyspnea (17 pts, 22%), and emaciation (10 pts, 13%). Eighteen patients (24%) were asymptomatic. Most patients were admitted due to shadows on chest X-rays. Lesions were more common in the lower lung (60 pts, 78.9%) than in the upper lung (25 pts, 32.9%). More lesions (28 pts, 37%) were characterized by patchy consolidations. Pulmonary cryptococcosis was confirmed histologically among all patients. Surgical removal of lesions or treatment with fluconazole and other antifungal agents for complete courses led to favorable outcomes for most patients.
Conclusions:
Primary pulmonary cryptococcosis was found mainly in immunocompetent patients aged <50 years without preexisting lung disease. Shadow on the chest X-ray is the predominant feature. Treatment with a complete course of fluconazole and/or other antifungal agents can achieve favorable outcome.
