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肺隐球菌病:一例诊断与管理难题的病例报告

Pulmonary Cryptococcosis: A Diagnostic and Management Challenge Case Report.

作者信息

Cardoso Kylee, Carroll Lisa

机构信息

Infectious Disease, Edward Via College of Osteopathic Medicine-Carolinas, Spartanburg, USA.

Family Medicine, Edward Via College of Osteopathic Medicine-Carolinas, Spartanburg, USA.

出版信息

Cureus. 2024 Apr 30;16(4):e59361. doi: 10.7759/cureus.59361. eCollection 2024 Apr.

Abstract

Cryptococcosis is a fungal infection that may arise in immunocompromised or immunocompetent individuals. This case report seeks to demonstrate the difficulty in diagnosing and treating cryptococcosis based on clinical presentation and radiographic features as together, they mimic other pathological conditions. A 56-year-old female with cirrhosis presented with persistent abdominal pain, dyspnea, vomiting, and diarrhea and was diagnosed with pulmonary cryptococcosis after an initial diagnosis of bacterial pneumonia. With no improvement following antibiotic therapy for suspected bacterial pneumonia, additional imaging was performed with a confirmatory lung biopsy for pulmonary cryptococcosis. The patient initiated antifungal therapy with the anticipation of completing approximately 12 months with follow-up imaging to evaluate improvement. After the patient experienced adverse effects of antifungal therapy and did not achieve significant improvement or recovery in her condition, it was apparent that cryptococcal pneumonia presents both diagnostic and management challenges that must be further explored.

摘要

隐球菌病是一种真菌感染,可发生于免疫功能低下或免疫功能正常的个体。本病例报告旨在说明基于临床表现和影像学特征诊断和治疗隐球菌病的困难,因为它们共同表现类似于其他病理状况。一名56岁的肝硬化女性患者出现持续性腹痛、呼吸困难、呕吐和腹泻,最初被诊断为细菌性肺炎,后被诊断为肺隐球菌病。在针对疑似细菌性肺炎进行抗生素治疗后病情无改善,遂进行了进一步的影像学检查,并通过肺活检确诊为肺隐球菌病。患者开始接受抗真菌治疗,预计疗程约12个月,并通过随访影像学检查评估病情改善情况。在患者经历了抗真菌治疗的不良反应且病情未取得显著改善或康复后,显然肺隐球菌病在诊断和管理方面均存在挑战,必须进一步探索。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7a6/11138369/c0e57fa573a3/cureus-0016-00000059361-i01.jpg

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