Retrospective analysis of 75 patients pathologically diagnosed with pulmonary cryptococcosis
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    Abstract:

    Objective:This study aims to investigate the clinical features,laboratory examinations,imaging characteristics,diagnosis and treatment of pulmonary cryptococcosis. Methods:The clinical data of 75 patients with pulmonary cryptococcosis,diagnosed from June 2009 to June 2019 in the First Affiliated Hospital of Nanjing Medical University,were retrospectively analyzed. According to the immune status,the enrolled patients were divided into an immunocompetent group with 43 cases and an immunocompromised group with 32 cases. Results:The patients consisted of 50 males and 25 females,with a mean age of(48.2±12.35)years(range,17 to 80 years). The main symptoms were cough,expectoration and fever. Twenty-seven patients were asymptomatic. There were differences in lymphocyte count,fibrinogen,carcinoembryonic antigen,cytokeratin 19 fragment and erythrocyte sedimentation rate in the two groups(P<0.05). Pulmonary cryptococcosis imaging showed no specificity,nodular or mass-like shadows in 33,patchy infiltrates or consolidation in 25 and mixed lesions in 17 cases,there were no statistically significant differences between the two groups(P>0.05). Up to September 30,2019,except for 4 cases of lost follow-up,59 cases received antifungal drug therapy alone and 12 cases received surgery combined with antifungal drug therapy. Forty-eight cases were cured,18 cases were improved and 5 cases died. The effective rate of fluconazole alone was 53/55(96.4%). Conclusion:Pulmonary cryptococcosis is commonly seen in immunocompetent patients and it has no specific clinical and imaging manifestations. The diagnosis mainly relies on pathological examination. The commonly used of antifungal drugs have better effect on pulmonary cryptococcosis. Most patients with pulmonary cryptococcosis have a good prognosis.

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周廉政,李 姗,张明顺,黄 茂,吉宁飞.肺隐球菌病75例回顾分析[J].南京医科大学学报(自然科学版英文版),2020,(5):725-731.

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  • Received:November 13,2019
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  • Online: June 10,2020
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