Clinical-imaging diversity of exudative pulmonary cryptococcosis with different immune states

Area of Science:

• Medical Imaging
• Infectious Diseases
• Pulmonology

Background:

• Pulmonary cryptococcosis (PC) is a fungal infection that can manifest with varied clinical and imaging features.
• The presentation of PC is influenced by the patient's immune status, leading to distinct diagnostic challenges.

Purpose of the Study:

• To investigate the clinical and imaging diversity of exudative pulmonary cryptococcosis (PC) in patients with different immune states.
• To identify key diagnostic features that differentiate PC in immunocompetent versus immunocompromised individuals.

Main Methods:

• Retrospective review of clinical and imaging data from 76 patients diagnosed with exudative PC.
• Comparison of findings between immunocompetent (36 cases) and immunocompromised (40 cases) patient groups.

Main Results:

• Immunocompromised PC showed higher rates of bilateral distribution (80.0%), ground-glass reticular patterns (52.5%), mediastinal lymphadenopathy (20.0%), and pleural effusion (22.5%).
• Immunocompetent PC was more frequently associated with inflammatory response (66.7%) and perifissural consolidation (52.8%).
• Statistically significant differences (P < 0.05) were observed for all compared features.

Conclusions:

• Exudative pulmonary cryptococcosis exhibits diverse clinical and imaging findings dependent on immune status.
• Specific imaging characteristics such as bilateral distribution, ground-glass patterns, lymphadenopathy, and pleural effusion can suggest PC in immunocompromised patients.
• Inflammatory response and perifissural consolidation may indicate PC in immunocompetent individuals, aiding clinical diagnosis and treatment strategies.