A case of miliary pulmonary cryptococcosis and review of literature.

Abstract

We describe a case of cryptococcal fungemia in a 62-year-old male renal transplant patient. The diagnosis was established by isolation of Cryptococcus neoformans using the Isolator(®) blood culture lysis-centrifugation system. Testing for cryptococcal antigens was negative in the serum and cerebrospinal fluid. Transbronchial lung biopsies and bronchoalveolar lavage were negative. Antifungal therapy with fluconazole was started, resulting in fever remission, and a sustained clinical response was achieved. The literature on miliary pulmonary cryptococcosis is reviewed, and three similar cases were previously reported with disseminated cryptococcosis that resembled miliary tuberculosis on imaging. These emphasize the importance of eliminating causes other than tuberculosis in patients presenting with miliary pulmonary disease, even in countries with a high prevalence of tuberculosis.

• Authors: Cecília Bittencourt Severo, Rosana Mussoin Bruno, Flávio de Mattos Oliveira, Paulo Zimmermann Teixeira, Bruno Hochhegger, Luiz Carlos Severo
• Journal: Mycopathologia (Mycopathologia) Vol. 179 Issue 3-4 Pg. 313-5 (Apr 2015) ISSN: 1573-0832 [Electronic] Netherlands
• PMID: 25563716 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antifungal Agents

Topics

• Antifungal Agents (administration & dosage)
• Cryptococcosis (diagnosis, drug therapy, etiology, microbiology)
• Humans
• Kidney Transplantation (adverse effects)
• Lung Diseases, Fungal (diagnosis, drug therapy, etiology, microbiology)
• Male
• Middle Aged