Kakeya H, Abe K, Yoshinaga M, Ishii H, Tomiyama Y, Maesaki S, Kadota J, Tomono K, Tashiro T, Kohno S
Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Oct;36(10):902-7.
We encountered two patients with pulmonary cryptococcosis that resolved spontaneously without antifungal treatment. A 59-year-old man (patient 1) and 37-year-old man (patient 2) were admitted to our hospital for the examination of abnormal shadows on their chest x-ray films. Transbronchial lung biopsies were performed, and cryptococci were detected in both patient's lung tissues. Latex aggultination tests for cryptococcal antigen were positive (1:16 and 1:4, respectively). The size of the shadows reduced spontaneously and the titers of the cryptococcal antigen in sera decreased within three months although no antifungal therapy was performed. Bronchoalveolar lavage fluid (BALF) was obtained from each patient and examined. In patient 1, the lymphocyte to CD 4/8 ratio was high in the BALF obtained on admission and the lymphocyte count was low; however, the CD 4/8 ratio was still high in a BALF sample obtained 3 months after discharge. In patient 2, the findings of the BALF analysis on admission were almost normal. The analysis of BALF may contribute to the immunological conditions to in the patients with pulmonary cryptococcosis.
我们遇到了两名肺隐球菌病患者,他们未经抗真菌治疗便自行痊愈。一名59岁男性(患者1)和一名37岁男性(患者2)因胸部X光片出现异常阴影而入院。进行了经支气管肺活检,两名患者的肺组织中均检测到隐球菌。隐球菌抗原乳胶凝集试验呈阳性(分别为1:16和1:4)。尽管未进行抗真菌治疗,但阴影大小在三个月内自行缩小,血清中隐球菌抗原滴度下降。从每位患者获取支气管肺泡灌洗液(BALF)并进行检查。在患者1中,入院时获取的BALF中淋巴细胞与CD 4/8比值较高,淋巴细胞计数较低;然而,出院3个月后获取的BALF样本中CD 4/8比值仍然较高。在患者2中,入院时BALF分析结果基本正常。BALF分析可能有助于了解肺隐球菌病患者的免疫状况。