Department of Infectious Diseases, Graduate School of Medicine, University of Tokyo, Tokyo 113-8655, Japan.
Respiration. 2010;79(2):153-6. doi: 10.1159/000216831. Epub 2009 Apr 29.
Cryptococcal infection is the 4th most common opportunistic infection in patients with acquired immune deficiency syndrome (AIDS). Although pleural effusion alone is an unusual presentation, we present a case of cryptococcal pleuritis in an AIDS patient which was initially difficult to discriminate from tuberculous pleuritis because of the high level of pleural adenosine deaminase (ADA). Cryptococcus neoformans was detected in the culture of the pleural effusion after the initiation of antituberculous treatment. High levels of ADA in the pleural fluid can be observed in patients with cryptococcal pleuritis, and longer incubation of pleural fluid should be performed in all patients who present with pleuritis associated with a high ADA level as the only significant finding.
隐球菌感染是获得性免疫缺陷综合征（AIDS）患者中第 4 常见的机会性感染。尽管单纯胸腔积液是一种不常见的表现，但我们报告了一例 AIDS 患者的隐球菌性胸膜炎，由于胸腔腺苷脱氨酶（ADA）水平高，最初难以与结核性胸膜炎区分。在开始抗结核治疗后，从胸腔积液中培养出新型隐球菌。在患有隐球菌性胸膜炎的患者中可以观察到胸腔积液中 ADA 水平升高，并且对于所有仅表现为高 ADA 水平的胸膜炎患者，应延长胸腔积液的孵育时间，因为这是唯一重要的发现。
