Chechani V, Kamholz S L
Department of Medicine, State University of New York Health Science Center, Brooklyn.
Chest. 1990 Nov;98(5):1060-6. doi: 10.1378/chest.98.5.1060.
Forty-eight patients with disseminated cryptococcosis and AIDS were retrospectively studied to define the pulmonary manifestations. Cryptococcus neoformans (CN) was first isolated from a pulmonary site in 12 patients. Disseminated disease was subsequently documented in all these patients. Symptoms and roentgenographic manifestations (normal, nodular/circumscribed infiltrates, pleural effusions, lobar consolidation) were diverse. Interstitial infiltrates predicted the presence of another opportunistic lung infection besides cryptococcosis in five patients (three untreated and two treated patients). Infectious causes other than cryptococcosis were established by culture and clinical course in five of the ten patients who developed chest roentgenographic abnormalities during amphotericin B therapy. Endobronchial abnormalities were identified in four patients at bronchoscopy. Bronchoalveolar lavage (9/9) and pleural fluid (3/3) cultures were sensitive tests for detection of pulmonary involvement with CN.
对48例播散性隐球菌病合并艾滋病患者进行回顾性研究以明确肺部表现。12例患者的新型隐球菌（CN）最初从肺部分离得到。随后所有这些患者均被记录有播散性疾病。症状和X线表现（正常、结节状/边界清晰的浸润影、胸腔积液、肺叶实变）多种多样。间质浸润提示5例患者（3例未治疗患者和2例已治疗患者）除隐球菌病外还存在其他机会性肺部感染。在两性霉素B治疗期间出现胸部X线异常的10例患者中，5例通过培养和临床病程确定了除隐球菌病以外的感染病因。4例患者在支气管镜检查时发现支气管内异常。支气管肺泡灌洗（9/9）和胸腔积液培养（3/3）是检测肺部是否受CN累及的敏感检查。
