Pediatr Infect Vaccine.  2021 Aug;28(2):124-131. 10.14776/piv.2021.28.e7.

Cryptococcosis with Mediastinal Lymph Node and Lung Involvement in an Immunocompetent Adolescent: A Case Report

Affiliations
  • 1Department of Pediatrics, Ewha Womans University Mokdong Hospital, Seoul, the Republic of Korea
  • 2Department of Radiology, Ewha Womans University Mokdong Hospital, Seoul, the Republic of Korea
  • 3Department of Radiology, Ewha Womans University College of Medicine, Seoul, the Republic of Korea
  • 4Department of Pathology, Ewha Womans University Seoul Hospital, Seoul, the Republic of Korea
  • 5Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, the Republic of Korea

Abstract

Cryptococcus neoformans is a fungus that primarily causes opportunistic infections in immunocompromised hosts. It can also cause various infections in immunocompetent patients. Pulmonary cryptococcosis involving the lymph node is relatively rare in immunocompetent patients. In this report, a previously healthy 17-year-old girl presented with high-grade fever and persistent cough. Chest X-ray and computed tomography (CT) scan revealed an anterior mediastinal conglomerate mass that expanded to the right supraclavicular area. Ultrasound-guided gun biopsy revealed histological evidence of cryptococcosis. Immunological screening tests did not identify immunodeficiency. She recovered completely with a combination therapy of amphotericin B and flucytosine for 2 weeks, followed by fluconazole for 8 months. The characteristics of cryptococcosis involving the mediastinal lymph node and the lung should be understood, and the possibility of cryptococcosis even in immunocompetent hosts should be considered.

Keyword

Cryptococcosis; Lung; Mediastinum; Lymphadenopathy; Adolescent
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