误诊为肺癌骨转移的播散性隐球菌病1例报道及文献复习

Disseminated cryptococcal bone infection misdiagnosed as bone metastasis of lung cancer:a case report

报道1例播散性的骨隐球菌感染的高龄男性患者的诊疗情况并文献复习,旨在加深对该病的认识,为临床医生提供经验,避免误诊。患者,男,83岁,因左侧髋部疼痛来院就诊,影像学检查提示肺癌伴骨转移可能性大,后行左侧大腿受累股骨穿刺活检术,病理诊断示骨隐球菌感染,经氟康唑治疗半年余疼痛逐渐好转,并定期门诊随访。隐球菌病累及骨较为罕见,易与肿瘤、结核等疾病相混淆,主要通过组织活检确诊,经抗真菌、手术治疗可好转或治愈,预后可。

To provide experience for clinicians and avoiding misdiagnosis of cryptococcal infection,a case of disseminated cryptococcal skeletal infection in an aged male was reported and the related literatures were reviewed.A 83-year-old male patient was admitted to our hospital complaining of pain in the left hip.Imaging examination suggested that lung cancer with bone metastasis was more likely,and then the left thighbone biopsy was performed.The pathological diagnosis showed cryptococcus osteophytosis infection.After fluconazole treatment for more than six months,the pain gradually improved,and regular outpatient follow-up was performed.Cryptococcal skeletal infection was relatively rare,and it was usually misdiagnosed as tumor,tuberculosis and other diseases.It was mainly diagnosed by biopsy,and could be improved or cured by antifungal and surgical treatment,with a good prognosis.