■隐球菌病是一种机会性真菌病,由革兰氏隐球菌引起的,C.新生主义者,C.Gattii很少见。[1],[2]感染发生在免疫抑制或免疫完整的患者中。传播主要发生在肺和脑膜,还有皮肤,骨头和前列腺,据报道,隐球菌性脑膜炎的死亡率从27%到近100%不等。[2],[3].
■我们报告一个健康的病例,具有6个月体重减轻史的免疫能力的男性,慢性咳嗽,近期发作的咯血和肺部肿块。鉴别诊断包括肺结核,细菌性或真菌性肺炎和肺癌。该患者随后被诊断为播散性C.gattii,这仍然非常罕见。这种感染的危险因素包括遥远的吸烟史,以及几个月前前往中部非洲进行休闲旅行。
■任何出现呼吸道或神经系统症状提示肺结核的患者都应考虑真菌感染,肺炎或肺癌,无论免疫能力如何。我们的案例强调了对所有患者进行彻底旅行史的重要性,因为鉴别诊断需要包括可能在旅行地区流行的非典型病原体。它还强调了与隐球菌病和药物相关毒性相关的显著发病率以及预防并发症的方法。
UNASSIGNED: Cryptococcosis is an opportunistic fungal disease, caused by Cryptococcus grubii, C. neoformans, and infrequently by C. gattii. [1], [2] Infection occur in patients with immunosuppression or with intact immunity. Dissemination mostly occurs in the lungs and meninges, but also the skin, bones and the prostate, with very high mortality rates reported for cryptococcal meningitis ranging from 27% to nearly 100%. [2], [3].
UNASSIGNED: We report the
case of a healthy, immunocompetent male presenting with a six-month history of weight loss, a chronic cough, recent-onset haemoptysis and a lung mass. The differential diagnosis included pulmonary Tuberculosis, bacterial or fungal pneumonia and lung carcinoma. The patient was subsequently diagnosed with disseminated C. gattii, which remains very rare. Risk factors for this infection included a distant history of cigarette smoking, as well as travel to central Africa for a recreational trip several months prior.
UNASSIGNED: Fungal infections should be considered in any patient presenting with respiratory or neurological symptoms suggestive of Tuberculosis, pneumonia or lung carcinoma, regardless of immunocompetency. Our
case highlights the importance of taking a thorough travel history in all patients, as the differential diagnosis would need to include atypical pathogens that could be endemic in the area of travel. It also highlights the significant morbidity associated with cryptococcosis and drug-related toxicities and the methods to prevent complications.