【3.9】2013年免疫抑制患者肺部隐球菌病诊疗.pdfVIP

Diagn Interv Radiol DOI 10.5152/dir.2013.13049 CHEST IMAGING ? Turkish Society of Radiology 2013 ORIGINAL ARTICLE Clinical and radiologic manifestations of pulmonary cryptococcosis in immunocompetent patients and their outcomes after treatment Thitiporn Suwatanapongched, Wasinan Sangsatra, Viboon Boonsarngsuk, Siriorn P. Watcharananan, Pimpin Incharoen PURPOSE ulmonary cryptococcosis is an emerging infection caused by We aimed to investigate clinical and radiologic manifesta- Cryptococcus species complex, which are ubiquitous encapsu- tions of pulmonary cryptococcosis in immunocompetent lated yeasts found worldwide. The infection usually affects patients and their outcomes after treatment. P immunocompromised patients, particularly those with an impaired MATERIALS AND METHODS cell-mediated immune response (1, 2). In rare circumstances, the in- We retrospectively reviewed the medical records, initial and follow-up chest computed tomography scans and/or radio- fection occurs in otherwise healthy individuals. According to pre- graphs for initial clinical and radiologic manifestations and vious studies from many countries in North America, Europe, and outcomes following antifungal treatment of 12 immunocom- petent patients diagnosed with pulmonary cryptococcosis the East (3–11), most immunocompetent individuals have mild between 1990 and 2012. or no clinical symptoms with isolated pulmonary involvement through single or multiple small pulmonary nodules. These find- RESULTS Twelve patients (age range, 21–62 years; males, 8 [66.7%]) ings are somewhat different from the more aggressive clinical and were included. Nine (75%) patients were symptomatic, eight radiographic findings described in isolated case reports among Thai of whom had disseminated infe