We reported an unusual case of disseminated cryptococcal lymphadenitis in an immunocompetent host who presented with fever and lymphadenopathy, which were the only two symptoms and signs. Latex agglutination test of s...We reported an unusual case of disseminated cryptococcal lymphadenitis in an immunocompetent host who presented with fever and lymphadenopathy, which were the only two symptoms and signs. Latex agglutination test of serum and cerebrospinal fluid （CSF） were negative, while lymph node biopsy showed Cryptococcus neoformans. A diagnosis of disseminated cryptococcal lymphadenitis was made. Then the patient was treated with amphotericin B for 15 days as initial therapy and itraconazole for 6 months as maintenance therapy respectively. The patient received re-examination per 6 months and was followed up for 2 years. Swollen lymph nodes diminished gradually, and no fever or other symptoms were found. Latex agglutination test of serum and CSF were negative throughout the follow-up period, and anti-HIV, syphilis and tuberculosis antibody were all negative.展开更多
BACKGROUND Cryptococcus presenting as an opportunistic pathogen mainly affects immunocompromised patients,but the disseminated form of infection is rare among immunocompetent populations.The partial radiographic chara...BACKGROUND Cryptococcus presenting as an opportunistic pathogen mainly affects immunocompromised patients,but the disseminated form of infection is rare among immunocompetent populations.The partial radiographic characteristics of pulmonary cryptococcosis mimic lung carcinoma,leading to unnecessary open chest exploratory surgery,and the lack of a gold-standard noninvasive diagnostic increases the risk of misdiagnosis.Positron emission tomography/computed tomography(PET/CT),a sensitive method for distinguishing malignant tumors,coupled with cryptococcal latex agglutination test showing a high positive rate may overcome these issues.CASE A 36-year-old man presented for general examination,without health complaints.Routine CT showed multiple pulmonary nodules and a mass with high maximum standardized uptake value.Initially,we suspected primary malignancy with hematogenous metastasis.Although his routine fungal analysis had been negative,subsequent CT-guided percutaneous core needle biopsy and histopathology examination indicated a diagnosis of pulmonary cryptococcosis.Fluconazole(200 mg/d)antifungal drug treatment was initiated,and 1 mo later the pulmonary mass had reduced in size markedly(on chest CT scan)without any complications.CONCLUSION Serologic and PET/CT examinations may not rule out cryptococcosis,and percutaneous lung puncture is critical under all circumstances.展开更多
文摘We reported an unusual case of disseminated cryptococcal lymphadenitis in an immunocompetent host who presented with fever and lymphadenopathy, which were the only two symptoms and signs. Latex agglutination test of serum and cerebrospinal fluid （CSF） were negative, while lymph node biopsy showed Cryptococcus neoformans. A diagnosis of disseminated cryptococcal lymphadenitis was made. Then the patient was treated with amphotericin B for 15 days as initial therapy and itraconazole for 6 months as maintenance therapy respectively. The patient received re-examination per 6 months and was followed up for 2 years. Swollen lymph nodes diminished gradually, and no fever or other symptoms were found. Latex agglutination test of serum and CSF were negative throughout the follow-up period, and anti-HIV, syphilis and tuberculosis antibody were all negative.
基金The Colleges and Universities in Anhui Province Natural Science Research Projects,No.KJ2018A0208.
文摘BACKGROUND Cryptococcus presenting as an opportunistic pathogen mainly affects immunocompromised patients,but the disseminated form of infection is rare among immunocompetent populations.The partial radiographic characteristics of pulmonary cryptococcosis mimic lung carcinoma,leading to unnecessary open chest exploratory surgery,and the lack of a gold-standard noninvasive diagnostic increases the risk of misdiagnosis.Positron emission tomography/computed tomography(PET/CT),a sensitive method for distinguishing malignant tumors,coupled with cryptococcal latex agglutination test showing a high positive rate may overcome these issues.CASE A 36-year-old man presented for general examination,without health complaints.Routine CT showed multiple pulmonary nodules and a mass with high maximum standardized uptake value.Initially,we suspected primary malignancy with hematogenous metastasis.Although his routine fungal analysis had been negative,subsequent CT-guided percutaneous core needle biopsy and histopathology examination indicated a diagnosis of pulmonary cryptococcosis.Fluconazole(200 mg/d)antifungal drug treatment was initiated,and 1 mo later the pulmonary mass had reduced in size markedly(on chest CT scan)without any complications.CONCLUSION Serologic and PET/CT examinations may not rule out cryptococcosis,and percutaneous lung puncture is critical under all circumstances.
