Tokuyasu Hirokazu, Harada Tomoya, Touge Hirokazu, Kawasaki Yuji, Chin Kazuo, Isowa Noritaka, Shimizu Eiji
Division of Respiratory Medicine, Matsue Red Cross Hospital.
Nihon Kokyuki Gakkai Zasshi. 2009 Jun;47(6):548-52.
In November 2007, a 30-year-old obese woman was admitted to our hospital with a complaint of persistent dry cough. Her chest-X-ray and computed tomography revealed multiple infiltrative shadows with air bronchograms in all lung fields. The bronchoalveolar lavage fluid revealed small bodies of Cryptococcus species. Cryptococcal serum antigen was also positive. To examine the cause of her snoring, polysomnography was done and revealed obstructive sleep apnea syndrome. The patient was given a diagnosis of primary pulmonary cryptococcosis with obstructive sleep apnea syndrome. After 12 months of treatment with fluconazole, the infiltrative shadows disappeared. Pulmonary cryptococcosis should be considered in the differential diagnosis of pulmonary multiple infiltrated shadows in patients without immunological abnormalities.
2007年11月，一名30岁的肥胖女性因持续性干咳入院。她的胸部X光和计算机断层扫描显示双肺野有多个伴有空气支气管征的浸润阴影。支气管肺泡灌洗液中发现隐球菌属的小体。隐球菌血清抗原也呈阳性。为检查其打鼾原因，进行了多导睡眠图检查，结果显示为阻塞性睡眠呼吸暂停综合征。该患者被诊断为原发性肺隐球菌病合并阻塞性睡眠呼吸暂停综合征。氟康唑治疗12个月后，浸润阴影消失。对于无免疫异常的肺部多发浸润阴影患者，鉴别诊断时应考虑肺隐球菌病。
