Martos A, Mascaró J, Santín M, Ariza J, Carratalà J, Podzamczer D
Servicio de Enfermedades Infecciosas, Hospital de Bellvitge-Prínceps d'Espanya, Barcelona.
Enferm Infecc Microbiol Clin. 1992 Dec;10(10):607-10.
We present here three AIDS patients with disseminated cryptococcal infection and lung involvement. Two patients presented with respiratory symptoms and in the third one, pulmonary disease was only a radiologic finding. Chest X-ray films showed an interstitial pattern in two cases and pulmonary cavitation in one case. One patient has also simultaneous infection by P. carinii. Diagnosis was established by culture from bronchoalveolar lavage in all cases and also by non-induced sputum exam in two cases. All patients were treated with amphotericin B, with good clinical outcome, and without relapses under maintenance therapy with fluconazole. Cryptococcosis must be included in differential diagnosis of AIDS patients with diffuse interstitial lung infiltrates. The presence of C. neoformans in respiratory samples does not rule out the existence of other opportunistic infections, and therefore bronchoalveolar lavage is advisable.
我们在此报告三例患有播散性隐球菌感染并累及肺部的艾滋病患者。两名患者出现呼吸道症状,第三名患者的肺部疾病仅为影像学表现。胸部X线片显示,两例为间质型,一例有肺空洞形成。一名患者同时合并卡氏肺孢子虫感染。所有病例均通过支气管肺泡灌洗培养确诊,两例还通过非诱导痰检查确诊。所有患者均接受两性霉素B治疗,临床效果良好,在接受氟康唑维持治疗期间无复发情况。隐球菌病必须纳入艾滋病患者弥漫性间质性肺浸润的鉴别诊断。呼吸道样本中存在新型隐球菌并不排除存在其他机会性感染,因此建议进行支气管肺泡灌洗。