原发性肺隐球菌病10例临床分析

Clinical analysis of 10 cases of primary pulmonary cryptococcosis

目的总结分析10例原发性肺隐球菌病患者的临床特点。方法分析我院10例原发性肺隐球菌病患者的临床、影像学表现、实验室检查、病理及确诊方法、疗效等。结果①10例原发性肺隐球菌病,男6例,女4例,有基础疾病者2例,有临床症状者8例,主要表现为胸痛、咳嗽、咳痰、痰中带血、发热,影像学表现为结节肿块型1例,肺炎型4例,混合病变型5例,全部病例均经病理确诊。②治疗采用手术切除病灶和(或)氟康唑治疗。1例行手术切除后口服氟康唑,另9例均行氟康唑治疗,治愈6例,好转4例,有效率100%,疗程1～12月不等。结论原发性肺隐球菌病临床和影像学表现不典型,呈多样性,应积极行肺活检以协助诊断,肺隐球菌病单用氟康唑抗真菌治疗效果良好。

Objective To increase the cognition of pulmonary cryptococcosis in analyzing its clinical characteristic. Methods Eight patients diagnosed as primary pulmonary cryptocoecosis in our hospital were included and in the study and their clinical characteristics, imaging findings, laboratory test, pathologies, antifungal therapies and follow-up results were studied. Results ① The patients consisted of 6 males and 4 females. 2 cases had basis diseases, and 8 cases had clinical symptoms. Imaging manifestation included mass and nodule change （ n = 1 ） , pneumonia-like change （ n = 4 ） , mix change （ n = 5 ）. All cases were conformed by pathology. ②Therapy methods included operation and anti-fungi drugs. One patient took orally fluconazole after operation and the others used fluconazole single （ effective rate 100% ）. There were 6 patients cared and 4 improved. Most of those cases were treated with fluconazole and the course or treatments ranged between one and six months. Conclusion Primary puhnonary cryptocoecosis shows various abnormalities in the clinical characteristics and images. CT findings of primary pulmonary cryptoeoceosis are not specific. The follow-up results are good in treating fluconazole.