Sakurai Hiroyuki, Kaji M, Seumasu K
Department of Thoracic Surgery, Saiseikai Central Hospital, Tokyo, Japan.
Kyobu Geka. 2009 Sep;62(10):863-7.
Pulmonary cryptococcosis is a fungal infection caused by the inhalation of Cryptococcus neoformans, and may progress to disseminated disease, particularly in immunocompromised host such as acquired immunodeficiency syndrome. We reported a retrospective review of the 8 patients who had undergone surgical resection for pulmonary cryptococcosis during recent 12 years. There were 5 men and 3 women with a mean age of 49 years. The number of lesions was solitary in 4 patients and multiple in 4 patients. All patients had neither symptom from the lesion nor human immunodeficiency virus infection. The most common computed tomography finding was well-defined solid nodules (<2 cm) of the lung. The lesion size ranged from 0.8 to 2.0 cm with a mean of 1.3 cm. Pathologically, the resected specimen revealed Cryptococcus fungal bodies in all cases. After surgery, 4 patients were treated with systemic antifungal therapy (fluconazole), and the others had no treatment. In all patients, no sign of relapse was found during the postoperative follow-up period. Although the prognosis of present cases was excellent regardless of the treatment after the surgery, the recommendation for the treatment in patients with pulmonary cryptococcosis is oral or intravenous fluconazole therapy because of the possible development of subclinical systemic disseminated disease.
肺隐球菌病是一种因吸入新型隐球菌引起的真菌感染,可能进展为播散性疾病,尤其是在获得性免疫缺陷综合征等免疫功能低下的宿主中。我们报告了对最近12年间因肺隐球菌病接受手术切除的8例患者的回顾性研究。其中男性5例,女性3例,平均年龄49岁。4例患者的病灶为单发,4例为多发。所有患者均无病灶相关症状,也未感染人类免疫缺陷病毒。计算机断层扫描最常见的表现是肺部边界清晰的实性结节(<2 cm)。病灶大小在0.8至2.0 cm之间,平均为1.3 cm。病理检查显示,所有切除标本均发现隐球菌菌体。术后,4例患者接受了全身抗真菌治疗(氟康唑),其余患者未接受治疗。所有患者在术后随访期间均未发现复发迹象。尽管无论术后治疗如何,目前这些病例的预后都很好,但由于可能发生亚临床系统性播散性疾病,肺隐球菌病患者的治疗建议为口服或静脉注射氟康唑治疗。