Chest Infections: Infections: Fungal |

Retrospective Analysis of 117 Chinese Patients With Pulmonary Cryptococcosis FREE TO VIEW

Jinbao Huang; Chang-qing Lan; Hong-yan Li; Qing-hua Lin; Jia-fu Liu; Heng Wen
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Department of Respiratory Medicine, Fuzhou Pulmonary Hospital of Fu Jian, Educational Hospital of Fujian Medical University, Fuzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A124. doi:10.1016/j.chest.2016.02.129
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SESSION TITLE: Infections: Fungal

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To investigate the clinical features of pulmonary cryptococcosis (PC).

METHODS: A total of 117 cases of PC, confirmed by pathological examinations at Fuzhou Pulmonary Hospital of Fu Jian from January 2009 to December 2013, were studied.

RESULTS: 101 of 117 cases (86.3%) were under 60 years old and 75 (64.1%%) were male patients.38 cases (32.5%) were immunocompromised host (ICH) and 79 cases (59.6%) were non-immunocompromised Host (NICH). The chest CT manifestations showed as follows: (1) All the lesions were manifested as three types: 66 cases (56.4%) showed nodular or mass-like shadows, 34 cases (29.1%) showed patchy infiltrates or consolidation, and 17cases (14.5%) showed mixed lesions. (2) There were a variety of CT signs accompanied,halo sign (78 cases,66.7%) and proximal air bronchogram (63 cases,53.8%) were the most common signs. Halo sign and proximal air bronchogram were more to seen in ICH than NICH (P=0.001;P=0.047). Halo sign and proximal air bronchogram were also more to seen in the patchy infiltrates or consolidation and mixed patterns than nodular or mass-like type of PC (P=0.007), but lobulation sign, spicule sign and pleural indentation were more to seen in the latter (P=0.000;P=0.000;P=0.005). (3) The lesions of PC were mainly found in right lung (40 cases, 34.2%), lower lobe (46 cases, 39.3%) and peripheral lung (105 cases, 90.6%). The geographic distribution of the lesions in NICH was more commonly involved multiple lobes than ICH (P=0.000). The geographic distribution of the nodule or mass lesions mainly in unilateral lung and single lobe, the patchy infiltrates or consolidation could be seen on all lung lobes, but the mixed lesions mainly in bilateral lung and multiple lobes (P=0.002; P=0.008). Multiple lesions were more to see in the the nodule or mass lesions and mixed lesions than the patchy infiltrates or consolidation (P=0.000). Enhanced CT scanning was made in 38 patients, 24 cases (63.2%) appeared as uniform enhancement and 27 cases (71.1%) showed moderate enhancement. The diagnosis was confirmed in all cases by pathological findings. 101 of 117 cases were treated in our hospital, 71 (70.3%) were cured and 30 (29.7%) were improved, no deaths.

CONCLUSIONS: The clinical symptom of PC is diverse and nonspecific. Halo sign and proximal air bronchogram are the characteristic CT manifestations of PC. Majority of patients can be obtained satisfactory results after the treatment of anti-fungi drugs and (or) surgical resection.

CLINICAL IMPLICATIONS: To deepen the understanding of the disease.

DISCLOSURE: The following authors have nothing to disclose: Jinbao Huang, Chang-qing Lan, Hong-yan Li, Qing-hua Lin, Jia-fu Liu, Heng Wen

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