Pisarevsky Ana Andrea, Larriera Alejandro, Cean Pilar, Petrucci Enrique A
Servicio de Medicina Interna, Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Argentina.
Medicina (B Aires). 2010;70(2):166-8.
The pulmonary cryptococcosis in immunocompetent patients is unusual, and its presentation as large masses with involvement of the chest wall and the neighboring soft tissues has not been found in our bibliographic research. The variety gattii (serotype B/C) is limited geographically to tropical and subtropical regions and appears to affect particularly immunocompetent individuals. We describe the case of a 51-year-old man from the Northeast of Argentina, with a history of smoking 10 pack/year. He presented an increased volume of the left shoulder and reported that for the last six months he had been unable to move it due to the pain. A percutaneous biopsy of the mass provided a diagnosis of Cryptococcus neoformans, variety gattii. The patient was treated with antifungal therapy showing a favourable outcome with a progressive decrease of the mass.
免疫功能正常患者的肺隐球菌病较为罕见，在我们的文献研究中尚未发现其表现为累及胸壁和邻近软组织的巨大肿块。加蒂变种（血清型B/C）在地理上局限于热带和亚热带地区，似乎特别易感染免疫功能正常的个体。我们描述了一名来自阿根廷东北部的51岁男性病例，他有每年吸烟10包的病史。他出现左肩肿大，并报告称在过去六个月里因疼痛而无法活动肩部。对肿块进行经皮活检，诊断为新生隐球菌加蒂变种。该患者接受了抗真菌治疗，肿块逐渐缩小，治疗效果良好。
