Kishida Naoki, Okinaka Keiji, Fujita Takahiro, Gu Yoshiaki, Ohmagari Norio
Division of Infectious Diseases, Shizuoka Cancer Center Hospital.
Kansenshogaku Zasshi. 2010 Sep;84(5):597-601. doi: 10.11150/kansenshogakuzasshi.84.597.
Cryptococcal lung disease is usually diagnosed by chest X-ray abnormalities. Although no treatment exists for asymptomatically immunocompetent patients, a case with central nervous system (CNS) involvement as cryptococcus dissemination had a new chest X-ray abnormality during marked eosinophilia diagnosed as pulmonary cryptococcosis by lung biopsy. Eosinophilia may thus be associated with pulmonary cryptococcosis. We had seen reports of disseminated cryptococcosis with eosinophilia, so we conducted lumbar puncture and blood culture, but found no disseminated lesion or CNS involvement. Eosinophilia association with disseminated cryptococcosis has been reported, but not pulmonary cryptococcosis with solitary localized lung lesion with marked eosinophilia, making our case the first, in so far as we know reported of pulmonary cryptococcosis with a solitary localized lung lesion with marked eosinophilia.
隐球菌性肺病通常通过胸部X线异常来诊断。虽然对于无症状的免疫功能正常患者无需治疗,但有一例因隐球菌播散累及中枢神经系统(CNS)的病例,在显著嗜酸性粒细胞增多期间出现了新的胸部X线异常,经肺活检诊断为肺隐球菌病。因此,嗜酸性粒细胞增多可能与肺隐球菌病有关。我们曾见过伴有嗜酸性粒细胞增多的播散性隐球菌病的报道,所以我们进行了腰椎穿刺和血培养,但未发现播散性病变或CNS受累。虽然已有嗜酸性粒细胞增多与播散性隐球菌病相关的报道,但尚无关于伴有显著嗜酸性粒细胞增多的孤立性局限性肺病变的肺隐球菌病的报道,就我们所知,我们的病例是首例伴有显著嗜酸性粒细胞增多的孤立性局限性肺病变的肺隐球菌病报道。