Tanaka Yuji, Satomi Kazuo
Department of Neurology, Gifu Municipal Hospital, Japan.
Intern Med. 2017;56(1):91-93. doi: 10.2169/internalmedicine.56.7056. Epub 2017 Jan 1.
We herein report the case of a 72-year-old-man with pulmonary cryptococcoma along with cryptococcal meningitis who underwent surgery for pulmonary lesions while receiving chemotherapy. We noted two major clinical issues. First, the presence of pulmonary cryptococcoma had a detrimental influence on the cryptococcal meningitis. Second, resolution of the pulmonary cryptococcoma through antifungal therapy had a beneficial influence on the recovery from cryptococcal meningitis. As observed in the current case with pulmonary and meningeal cryptococcosis, surgery for pulmonary cryptococcoma with continuous antifungal treatment should be considered for cases where the symptoms respond poorly to antifungal therapy and radiographic abnormalities persist.
我们在此报告一例72岁男性患者，患有肺隐球菌瘤合并隐球菌性脑膜炎，在接受化疗期间因肺部病变接受了手术。我们注意到两个主要临床问题。第一，肺隐球菌瘤的存在对隐球菌性脑膜炎有不利影响。第二，通过抗真菌治疗使肺隐球菌瘤消退对隐球菌性脑膜炎的恢复有有益影响。正如在当前这例肺和脑膜隐球菌病病例中所观察到的，对于抗真菌治疗症状反应不佳且影像学异常持续存在的病例，应考虑对肺隐球菌瘤进行手术并持续进行抗真菌治疗。
