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Clinicoradiological Features of Pulmonary Cryptococcosis in Immunocompetent Patients
Insights
Pulmonary cryptococcosis in immunocompetent patients often presents as a single nodular lesion. However, a consolidation-dominant pattern combined with a positive serum cryptococcal antigen test may aid diagnosis.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- Pulmonary cryptococcosis is a fungal infection that can affect the lungs.
- While often seen in immunocompromised individuals, it can also occur in immunocompetent patients.
- Understanding its clinicoradiological features is crucial for accurate diagnosis.
Purpose of the Study:
- To evaluate the clinicoradiological characteristics of pulmonary cryptococcosis in immunocompetent individuals.
- To identify imaging patterns and their association with serum cryptococcal antigen levels.
Main Methods:
- Retrospective analysis of chest CT scans from immunocompetent patients diagnosed with pulmonary cryptococcosis.
- Categorization of imaging features into patterns, distributions, and ancillary findings.
- Univariable analysis to correlate imaging features with serum cryptococcal antigen status.
Main Results:
- Thirty-one immunocompetent patients were included (mean age 60 years).
- The most frequent imaging pattern was a single nodular lesion in one lobe (45.2%).
- Serum cryptococcal antigen was positive in 31.6% of tested patients and significantly associated with a consolidation-dominant pattern (p=0.011).
Conclusions:
- A single nodular lesion is a common presentation of pulmonary cryptococcosis in immunocompetent patients.
- The combination of CT findings showing consolidation and a positive serum cryptococcal antigen test is a valuable diagnostic clue.
- This approach can improve the early detection and management of pulmonary cryptococcosis in this patient group.
Purpose:
To assess the clinicoradiological features of pulmonary cryptococcosis in immunocompetent patients.
Materials And Methods:
This retrospective study included immunocompetent patients who had been diagnosed with pulmonary cryptococcosis on the histopathologic exam and underwent chest CT between January 2008 and November 2019. Imaging features were divided into major imaging patterns, distributions, and ancillary imaging findings. Univariable analysis was performed to evaluate clinicoradiological features according to the presence of serum cryptococcal antigen.
Results:
Thirty-one patients were evaluated (mean age: 60 years, range: 19-78 years). A single nodular lesion confined to a single lobe was the most common imaging pattern (14/31, 45.2%). Serum cryptococcal antigen tests were performed in 19 patients (19/31, 61.3%). The presence of serum cryptococcal antigen was observed in six patients (6/19, 31.6%), all of whom showed a consolidation-dominant pattern. The presence of serum cryptococcal antigen was significantly associated with the consolidation-dominant pattern compared to those associated with a nodule-dominant pattern (p = 0.011).
Conclusion:
A combination of CT findings of consolidation and a positive serum cryptococcal antigen test may be helpful for diagnosing pulmonary cryptococcosis in immunocompetent patients.
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