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Case Reports
. 2019 May 2:27:100851.
doi: 10.1016/j.rmcr.2019.100851. eCollection 2019.

Cryptococcosis as a cause of organizing pneumonia

Ayumi Chikumoto  1 , Keiji Oishi  2 , Kazuki Hamada  1 , Kazuki Matsuda  1 , Sho Uehara  1 , Ryo Suetake  1 , Yoshikazu Yamaji  1 , Maki Asami-Noyama  1 , Nobutaka Edakuni  1 , Tsunahiko Hirano  1 , Tomoyuki Murakami  3 , Kazuto Matsunaga  1
Affiliations
Case Reports

Cryptococcosis as a cause of organizing pneumonia

Ayumi Chikumoto et al. Respir Med Case Rep. .

Abstract

In cases showing organizing pneumonia (OP) with radiologic findings and pathological images, it is necessary to differentiate between idiopathic and secondary diseases as the cause of OP. Cryptococcus infection as a cause of OP is not well known. We herein report two cases of secondary pulmonary cryptococcosis in immunocompromised patients who showed OP, and the usefulness of bronchoscopy and serum cryptococcal antigen test for an early diagnosis. Common to both cases was that antibiotic therapy and corticosteroid therapy were ineffective, while antifungal agents were effective. In cases of immunocompromised patients who present OP with radiologic findings or pathological images, prompt administration of antifungal treatment at an early stage is important when pulmonary cryptococcosis is identified by bronchoscopy and serum cryptococcal antigen test.

Keywords: Bronchoscopy; Cryptococcosis; Immunocompromised host; Organizing pneumonia; Serum cryptococcal antigen test.

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Figures

Fig. 1
Fig. 1
(a) Chest CT revealed right dominant non-segmental infiltrative shadows, multiple nodules, and right pleural effusion. (b) Hematoxylin and eosin staining, detecting some of the alveolar spaces containing Masson bodies (circles) and showing high fibrin precipitation and bleeding (arrows). (c) Grocott's silver staining showing the spherical fungi of different sizes. (d) Treatment course of patient 1.
Fig. 2
Fig. 2
(a) Chest CT revealed non-segmental infiltrative shadows with air bronchogram and surrounding ground-glass opacity in bilateral lungs. (b) A few spores of cryptococcus yeast were detected in the smear of BALF by Grocott's silver stain. (c) Treatment course of patient 2.
See this image and copyright information in PMC

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