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Abstract To investigate the clinical characteristics of community-acquired pulmonary cryptococcosis, a total of 55 cases of pulmonary cryptococcosis diagnosed at Zhongshan Hospital, Fudan University from 2003 to 2009 were retrospectively analyzed. The patients were consisted of 34 males and 21 females , with median age of 44.8±13.4 (17 to 75) years , 69.1 % of whom had no underlying diseases. Among those patients, 38.2% were asymptomatic, and 61. 8% had respiratory and (or) constitutional symptoms. The common symptoms were cough/ expectoration, fever , chest pain , and dyspnea on exertion. The common computed tomography (CT) scan patterns were nodule and mass, either solitary or multiple (53.0%) , infiltration and consolidation (31. 4 %), or diffused and mixed lesions (15. 7%). Twenty-five patients underwent latex agglutination test for pulmonary cryptococcosis, and 100% were positive. Cryptococcus neoformans was found in four biopsy tissue smears, in one sputum culture , and in two bronchoscopic lavage fluid cultures Non-caseous granuloma was the main characteristic in pathological study, with multinucleated giant cells containing abundant vacuolus yeast forms shown by periodic acid-Schiff (PAS) reaction and/ or GrocottGomori' s methenamine silver (GMS) staining. In conclusion, community-acquired pulmonary cryptococcosis is more prevalent in middle-aged male patients, the symptoms are mild, and the imaging patterns are multiple. Pathological, etiological, and serological examinations are valuable diagnostic tools.
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Received: 24 May 2011
Published: 25 September 2011
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Corresponding Authors:
LI Hua-Yin
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