[Pulmonary cryptococcosis in a non-HIV patient].

Abstract

Cryptococcosis is an opportunistic and conditional disease. The lungs and central nervous system are common organs invaded by Cryptococcus. Most patients with pulmonary cryptococcosis are immunocompromised, such as acquired immune deficiency síndrome, subjects with immunosupressive drugs and hematological malignancies. We present an immunocompetent 46-year-old man with diabetes mellitus, who had cough, chest pain and weight loss. Computed tomography of thorax demonstrated a pulmonary nodule in the right upper lobe, measuring 8.5 cm. To confirm the diagnosis, the patient underwent CT-guided biopsy of the nodule. Pathology revealed round structures with asymmetric budding on Periodic acid-Schiff-diastase, Grocott methenamine silver and mucicarmine stains, morphologically compatible with Cryptococcus sp. Serum cryptococcal antigen was positive. Once the diagnosis of isolated pulmonary cryptococcosis was confirmed, the patient was treated with oral fluconazole 400 mg daily for 6 months. The treatment response was categorized as partial resolution, and the patient underwent a right upper lobectomy. Pulmonary cryptococcosis in non-HIV patients is a relatively common, and in some of them is difficult to differentiate from lung cancer.