Maepa H M
Division of Pulmonology, Chris Hani Baragwanath Academic Hospital, and School of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Afr J Thorac Crit Care Med. 2019 Dec 6;25(4). doi: 10.7196/AJTCCM.2019.v25i4.002. eCollection 2019.
Pulmonary cryptococcosis is a fungal infection caused by inhalation of and/or spores. It mostly affects HIV-infected patients. This is a case report of a severely immunocompromised HIV-infected patient, presenting with respiratory symptoms and atypical chest X-ray features for pulmonary cryptococcosis. A serum cryptococcal latex antigen test is positive in a majority of HIV-infected patients with pulmonary cryptococcosis. This case report demonstrates the occurrence of a false negative serum cryptococcal latex antigen test, becoming positive with the development of an unmasking immune reconstitution syndrome (after antiretroviral therapy was commenced). This also resulted in the characteristic cryptococcal lung cavities observed on computed tomography chest images. Duration of fluconazole therapy should be individualised, and serial chest imaging (e.g. chest X-ray) should be performed to monitor treatment response.
肺隐球菌病是一种因吸入新型隐球菌和/或格特隐球菌孢子而引起的真菌感染。它主要影响感染人类免疫缺陷病毒（HIV）的患者。本文报告了一例免疫功能严重受损的HIV感染患者，该患者出现呼吸道症状，胸部X线表现不典型，符合肺隐球菌病的特征。大多数患有肺隐球菌病的HIV感染患者血清隐球菌乳胶凝集试验呈阳性。本病例报告显示，血清隐球菌乳胶凝集试验出现假阴性结果，在开始抗逆转录病毒治疗后，随着免疫重建综合征的出现转为阳性。这也导致了胸部计算机断层扫描图像上观察到典型的隐球菌肺空洞。氟康唑治疗的疗程应个体化，并且应进行系列胸部影像学检查（如胸部X线）以监测治疗反应。
