Journal
JOURNAL OF THORACIC DISEASE
Volume 8, Issue 10, Pages 2813-2821Publisher
AME PUBL CO
DOI: 10.21037/jtd.2016.10.36
Keywords
Pulmonary cryptococcosis; computed tomography; Non-AIDS patient; immune status
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Funding
- Natural Science Foundation of China [81370182]
- National Basic Research Program (973 Program) in China [2013CB531402]
- Medical Scientific Research Foundation of Fujian Province [2012-CX-23]
- Shanghai Subject Chief Scientist Program [07XD14012]
- Shanghai Leading Talent Projects [036, 2010]
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Background: Pulmonary cryptococcosis (PC) was not a rare infectious disease in non-AIDS patients. However, data on the immune status were lacking in southern China for comparative analysis of differences between immunocompromised and immunocompetent hosts. This study was to investigate the epidemiological, clinical, radiological, and treatment profiles for patients with PC. Methods: We performed a retrospective review of 88 patients diagnosed with tissue-confirmed PC who were not HIV-infected from 2003 to 2013. Results: Of 88 patients, 35(39.7%) were immunocompromised host. Fever and CNS symptom were significantly common in immunocompromised patients compared to immunocompetent patients (P=0.019 and P=0.036, respectively). The most frequent radiologic abnormalities were solitary or multiple pulmonary nodules, and masses or consolidations, and most lesions were located in the peripheral lung field. Cavitations and halo sign were significantly frequent in immunocompromised patients than in immunocompetent patients (P<0.05). The most frequently applied and reliable diagnostic procedure was CT-guided percutaneous translung biopsy. Treatment included antifungal drug alone in 20 patients, surgery alone in 20 including 3 treated by VATS, surgery plus antifungal drugs in 20 patients. Conclusions: PC was not rare in immunocompetent host in southern China. Special differences remained in clinical manifestation and radiological findings of PC between immunocompromised and immunocompetent patients. Future work on the mechanisms of possible differences is required.
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