Kaixiong Liu1, Haibo Ding1, Bing Xu2, Ruixiong You3, Zhen Xing3, Jianfeng Chen4, Qichang Lin1, Jieming Qu5. 1. Department of Respiratory disease, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China;; Laboratory of Respiratory Disease of Fujian Medical University, Fuzhou 350005, China. 2. Department of Neurology, Fujian Geriatric Hospital, Fuzhou 350003, China. 3. Department of Radiology, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China. 4. Department of thoracic surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China. 5. Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai 200040, China.
Abstract
BACKGROUND: Pulmonary cryptococcosis (PC) was not a rare infectious disease in non-AIDS patients. However, data on the immune status were lacking in southern China for comparative analysis of differences between immunocompromised and immunocompetent hosts. This study was to investigate the epidemiological, clinical, radiological, and treatment profiles for patients with PC. METHODS: We performed a retrospective review of 88 patients diagnosed with tissue-confirmed PC who were not HIV-infected from 2003 to 2013. RESULTS: Of 88 patients, 35(39.7%) were immunocompromised host. Fever and CNS symptom were significantly common in immunocompromised patients compared to immunocompetent patients (P=0.019 and P=0.036, respectively). The most frequent radiologic abnormalities were solitary or multiple pulmonary nodules, and masses or consolidations, and most lesions were located in the peripheral lung field. Cavitations and halo sign were significantly frequent in immunocompromised patients than in immunocompetent patients (P<0.05). The most frequently applied and reliable diagnostic procedure was CT-guided percutaneous translung biopsy. Treatment included antifungal drug alone in 20 patients, surgery alone in 20 including 3 treated by VATS, surgery plus antifungal drugs in 20 patients. CONCLUSIONS: PC was not rare in immunocompetent host in southern China. Special differences remained in clinical manifestation and radiological findings of PC between immunocompromised and immunocompetent patients. Future work on the mechanisms of possible differences is required.
BACKGROUND:Pulmonary cryptococcosis (PC) was not a rare infectious disease in non-AIDSpatients. However, data on the immune status were lacking in southern China for comparative analysis of differences between immunocompromised and immunocompetent hosts. This study was to investigate the epidemiological, clinical, radiological, and treatment profiles for patients with PC. METHODS: We performed a retrospective review of 88 patients diagnosed with tissue-confirmed PC who were not HIV-infected from 2003 to 2013. RESULTS: Of 88 patients, 35(39.7%) were immunocompromised host. Fever and CNS symptom were significantly common in immunocompromised patients compared to immunocompetent patients (P=0.019 and P=0.036, respectively). The most frequent radiologic abnormalities were solitary or multiple pulmonary nodules, and masses or consolidations, and most lesions were located in the peripheral lung field. Cavitations and halo sign were significantly frequent in immunocompromised patients than in immunocompetent patients (P<0.05). The most frequently applied and reliable diagnostic procedure was CT-guided percutaneous translung biopsy. Treatment included antifungal drug alone in 20 patients, surgery alone in 20 including 3 treated by VATS, surgery plus antifungal drugs in 20 patients. CONCLUSIONS: PC was not rare in immunocompetent host in southern China. Special differences remained in clinical manifestation and radiological findings of PC between immunocompromised and immunocompetent patients. Future work on the mechanisms of possible differences is required.
Entities:
Keywords:
Non-AIDS patient; Pulmonary cryptococcosis; computed tomography; immune status
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