Pulmonary cryptococcosis: localized and disseminated infections in 27 patients with AIDS.

Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Pulmonary cryptococcosis: localized and disseminated infections in 27 patients with AIDS.

Clin Infect Dis. 1995 Sep;21(3):628-33. Unique Identifier : AIDSLINE MED/96077385
Meyohas MC; Roux P; Bollens D; Chouaid C; Rozenbaum W; Meynard JL; Poirot JL; Frottier J; Mayaud C; Service des Maladies Infectieuses et Tropicales, Hopital; Saint-Antoine, Paris, France.

Abstract: We reviewed the records of 85 patients infected with both human immunodeficiency virus and Cryptococcus neoformans. Twenty-seven patients (32%) had pulmonary cryptococcosis. C. neoformans was cultured from bronchoalveolar lavage (BAL) or pleural fluid in 25 cases; the remaining two patients had cryptococcal antigen (CA) detected in BAL fluid and C. neoformans cultured from other sites. All but one of the 27 patients had detectable CA in serum. The CD4+ lymphocyte count was low in all cases (median, 24/mm3). Clinical manifestations of pulmonary cryptococcosis included fever (94%), cough (71%), dyspnea (7%), expectoration (4%), chest pain (2%), and hemoptysis (1%). Diffuse interstitial opacities (70.5%), focal interstitial abnormalities, alveolar opacities, adenopathies, cavitary lesions, and pleural effusions were evident. Outcome was poor (mean survival time, 23 weeks) despite treatment. Patients with localized pulmonary cryptococcosis appeared to have a higher CD4+ lymphocyte count, an earlier diagnosis, lower serum CA titers, fewer previous or concomitant infections, and a better prognosis than patients with disseminated cryptococcosis.

Keywords: Adult Antigens, Fungal/ISOLATION & PURIF AIDS-Related Opportunistic Infections/*DIAGNOSIS/IMMUNOLOGY Bronchoalveolar Lavage Fluid/IMMUNOLOGY/MICROBIOLOGY Cryptococcosis/*COMPLICATIONS/DIAGNOSIS/IMMUNOLOGY Cryptococcus neoformans/IMMUNOLOGY/ISOLATION & PURIF CD4 Lymphocyte Count Female Human Lung Diseases, Fungal/*COMPLICATIONS/DIAGNOSIS/IMMUNOLOGY Male Middle Age Prognosis JOURNAL ARTICLE
960430
M9640831

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