Thangakunam B, Christopher D J, Kurian S, Thomas R, James P
Department of Pulmonary Medicine and Pathology , Christian Medical College, Vellore, Tamil Nadu, India.
Lung India. 2008 Oct;25(4):155-7. doi: 10.4103/0970-2113.45281.
Pulmonary cryptococcosis usually occurs as an opportunistic infection in immunocompromised patients. Endogenous Cushing's syndrome is associated with cortisol excess and can predispose to development of cryptococcal infections. We report a case of diabetic patient with ACTH secreting pituitary tumour who developed a cavitating lung mass. Computed tomography-guided biopsy of the lesion revealed mucicarminophilic budding forms of cryptococcus. Broncheoalveolar lavage culture grew Cryptococcus neoformans. There was radiological response to treatment with liposomal Amphotericin, but patient ultimately succumbed to septicemia and multiorgan failure. Opportunistic infections with organisms like Cryptococcus neoformans, should be considered in patients with endogenous Cushing's syndrome and a pulmonary infiltrate.
肺隐球菌病通常作为免疫功能低下患者的机会性感染发生。内源性库欣综合征与皮质醇过多有关，可易患隐球菌感染。我们报告一例患有促肾上腺皮质激素分泌性垂体瘤的糖尿病患者，该患者出现了肺空洞性肿块。病变的计算机断层扫描引导下活检显示出隐球菌的嗜黏液卡红芽生形式。支气管肺泡灌洗培养培养出新型隐球菌。脂质体两性霉素治疗有放射学反应，但患者最终死于败血症和多器官功能衰竭。对于内源性库欣综合征和肺部浸润的患者，应考虑像新型隐球菌这样的病原体引起的机会性感染。
