Tuberc Respir Dis.  1995 Aug;42(4):618-623.

A Case of Cryptococcosis involving Lung and CNS without Underlying Disease

• Lee MS
• Park SS
• Koh YI
• Jang AS
• Lim SC
• Yang JY
• Park HK
• Na HJ
• Kim YC
• Choi IS
• Park KO

Abstract

Cryptococcosis is a systemic mycosis that most often involves the lungs and central nervous system and, less frequently, the skin, skeletal system, and prostate gland. Cryptococcus neoformans, the causative organism, is a yeastlike round or oval fungus, 4 to 6microm in diameter, which is surrounded by a polysaccharide capsule and reproduces by budding and found in soil and other enviromental areas, especially those contaminated by pigeon droppings. Humans and aninmals acquire infection after inhalation of aerosolized spores. Condition or factors that predispose to cryptococcosis include corticosteroid therapy, lymphoreticular malignancies, HIV infection, and sarcoidosis etc. We discribed a case of cryptococcosis involving lung and CNS coincidently without specific underlying disease and the literature on subject were reviewed. A fifty-six year-old previously healthy female presented with headache of 3 months of duration. She had no history suggesting immunologic suppression and we could not find any abnormal laboratory findings including blood sugar, serum immunoglobulin and complement level, HIV antibody, and T cell subsets. Chest roentgenogram and CT scan showed a solitary soft tissue mass in LUL with distal pneumonitis. Brain MRI showed granulomatous lesion in cerebellum and parasagittal cortex of right frontal lobe. The diagnosis was made by bronchoscopic brushing cytology, transthoracic fine needle aspiration, and sputum OH mount and culture. She was treated 6 weeks course of Amphotericin B and switched to oral fluconazole therapy for 3 months. Her symptoms and X-ray findings were improved gradually and she is now under regular clinical follow up.

Keyword

Cryptococcosis; Lung and CNS invasion

MeSH Terms

Amphotericin B
Biopsy, Fine-Needle
Blood Glucose
Brain
Central Nervous System
Cerebellum
Columbidae
Complement System Proteins
Cryptococcosis*
Cryptococcus neoformans
Diagnosis
Female
Fluconazole
Follow-Up Studies
Frontal Lobe
Fungi
Headache
HIV
HIV Infections
Humans
Immunoglobulins
Inhalation
Lung*
Magnetic Resonance Imaging
Pneumonia
Prostate
Sarcoidosis
Skin
Soil
Spores
Sputum
T-Lymphocyte Subsets
Thorax
Tomography, X-Ray Computed
Amphotericin B
Blood Glucose
Complement System Proteins
Fluconazole
Immunoglobulins
Soil