Solitary cavitary pulmonary nodule may be a common CT finding in AIDS-associated pulmonary cryptococcosis

Abstract Background Cryptococcus is one of the major fungal pathogens infecting the lungs. Pulmonary cryptococcal infection is generally considered a community-acquired condition caused by inhalation of dust contaminated with fungal cells from the environment. Here, we report a case developing pulmonary cryptococcosis 3 months after hospital admission, which has rarely been reported before. Case presentation A 73-year-old female patient who was previously immunocompetent experienced persistent dry cough for 2 weeks, 3 months after admission. Chest computed tomography (CT) showed a new solitary pulmonary nodule developed in the upper lobe of the left lung. Staining and culture of expectorated sputum smears were negative for bacteria, acid-fast bacilli, or fungus. The patient then underwent biopsy of the lesion. Histopathology findings and a positive serum cryptococcal antigen titer (1:8) indicated pulmonary cryptococcosis. Daily intravenous 400 mg fluconazole was administered initially followed by oral fluconazole therapy. Follow-up chest CT after 3 months of antifungal therapy showed complete disappearance of the pulmonary nodule. Respiratory symptoms of the patient also resolved. A complete investigation excluded the possibility of a patient-to-patient transmission or primarily acquiring the infection from the hospital environment. Based on the patient’s history of exposure to pigeons before admission and recent steroid and azathioprine use after admission for the treatment of myasthenic crisis, reactivation of a latent pulmonary cryptococcal infection acquired before admission, in this case, is impressed. Conclusions Although rarely reported, pulmonary cryptococcal infection should be included in the differential diagnosis of hospitalized patients with respiratory symptoms, especially in those with predisposing risk factors. Chest image studies and further surgical biopsy are needed for confirmation.

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Pulmonary Cryptococcosis Presenting Solitary Pulmonary Nodule in an Immunocompetence: A Case Report and Review of the Korean Literatures

Soonchunhyang Medical Science ◽

10.15746/sms.11.026 ◽

2011 ◽

Vol 17 (2) ◽

pp. 122-126

Author(s):

Jung Hwan Lee ◽

Ji Taek Hong ◽

Chun Ho Shin ◽

Lucia Kim ◽

Kyung Hee Lee ◽

...

Keyword(s):

Case Report ◽

Pulmonary Nodule ◽

Solitary Pulmonary Nodule ◽

Pulmonary Cryptococcosis

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Lungenrundherd im CT - Beobachten oder resezieren?

Therapeutische Umschau ◽

10.1024/0040-5930/a000305 ◽

2012 ◽

Vol 69 (7) ◽

pp. 394-400 ◽

Cited By ~ 1

Author(s):

Odermatt ◽

Furrer

Keyword(s):

Pulmonary Nodule ◽

Fdg Pet ◽

Solitary Pulmonary Nodule ◽

Sensitivität Und Spezifität ◽

Wird Eine ◽

Chirurgische Resektion

Zufällig entdeckte solitäre Lungenrundherde (Solitary pulmonary nodule, SPN) nehmen aufgrund des vermehrten Einsatzes von hochauflösenden CTs zu. Sie werden definiert als bis zu 3cm große Verdichtungen ohne Hinweise auf vergrößerte Lymphknoten. Radiologische Morphologiekriterien und Wachstumsdynamik sowie das Patientenrisikoprofil (Alter, Raucheranamnese, Malignomanamnese) dienen zur Einteilung des Malignomrisikos in gering, mittel oder hoch. Bei geringer Malignitätswahrscheinlichkeit wird der SPN beobachtet. Bei mittlerer Malignitätswahrscheinlichkeit wird eine transthorakale oder bronchoskopische Biopsie empfohlen. Diese ist aber nur aussagekräftig, wenn eine maligne oder eindeutig benigne Entität diagnostiziert wird. In allen anderen Fällen bleibt der SPN undeterminiert und die chirurgische Resektion ist angezeigt. Zunehmend wird bei mittlerem Malignitätsrisiko oder Patienten mit hohem Operationsrisiko das FDG-PET zur Bestimmung der Vortest-Wahrscheinlichkeit eingesetzt. Die Sensitivität ist etwa 80%. SPN mit hoher Malignitätswahrscheinlichkeit werden primär reseziert. Die chirurgische Resektion gilt als Goldstandard mit Sensitivität und Spezifität von praktisch 100%. Im Falle von Metastasen ist die Exzisionsbiopsie therapeutisch. Als chirurgisches Verfahren hat sich die videoassistierte thorakoskopische (VATS) Keilexzision etabliert. Hierfür geeignet sind periphere Herde von 1 - 2 cm Größe, die nicht tiefer als ihr Eigendurchmesser im Lungenparenchym liegen. Konzeptionell ist im Falle eines intraoperativ nachgewiesenen nicht-kleinzelligen Bronchuskarzinoms (NSCLC) die zweizeitige oder einzeitige Operation möglich. Beim einzeitigen Verfahren wird Diagnostik und onkologische Resektion in der gleichen Operation durchgeführt. Aufgrund der meist vorliegenden Frühstadien kann die Lobektomie videoassistiert erfolgen. Die diagnostische Thorakotomie mit offener Biopsie ist selten zur Klärung der Diagnose nötig. Zur Planung einer effizienten und individuellen Abklärung ist ein interdisziplinärer Approach essentiell.

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Computer tomography (CT) finding of normal pancreas

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1983.19.4.767 ◽

1983 ◽

Vol 19 (4) ◽

pp. 767

Author(s):

C J Cho ◽

B T Kim ◽

J S Lee

Keyword(s):

Computer Tomography ◽

Normal Pancreas ◽

Ct Finding

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Detection of Diffuse calcification in a Pulmonary Nodule: Diagnostic Accuracy of Chest Radiolograph and correlation with CT

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1996.34.5.599 ◽

1996 ◽

Vol 34 (5) ◽

pp. 599

Author(s):

Sang Jin Kim ◽

Hyung Jung Kim ◽

Tae Hoon Kim ◽

Chang Su Ahn

Keyword(s):

Diagnostic Accuracy ◽

Pulmonary Nodule ◽

Diffuse Calcification

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A Rare Case Of Solitary Pulmonary Nodule Pulmonary Actinomycosis

Acta Medica Anatolia ◽

10.15824/actamedica.89140 ◽

2014 ◽

Vol 2 (4) ◽

Author(s):

Murat Acat ◽

Zehra Yasar ◽

Akif Ozgul ◽

Erhan Dincer ◽

Neslihan Fener ◽

...

Keyword(s):

Pulmonary Nodule ◽

Rare Case ◽

Solitary Pulmonary Nodule ◽

Pulmonary Actinomycosis

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Incidence of Cerebral Hemorrhage in Traumatic Patients using Computed Tomography in Tabuk City, Saudi Arabia

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol05-i10/971 ◽

2020 ◽

Vol 5 (10) ◽

pp. 460-463

Author(s):

Amna Mohamed Ahmed ◽

Towmader Awad ◽

Hajer Yousif ◽

Reem Nahari ◽

Omnia Abdelrhman ◽

...

Keyword(s):

Computed Tomography ◽

Saudi Arabia ◽

Head Trauma ◽

Subdural Hematoma ◽

Cerebral Hemorrhage ◽

Imaging Modality ◽

Common Type ◽

Radiology Department ◽

Age Group ◽

Ct Finding

Computed Tomography (CT) is the most commonly used imaging modality in the evaluation of cerebral hemorrhage in the head trauma patients. Objective: To study the incidence of a cerebral hemorrhage in traumatic patients using computed tomography. Method: This retrospective study was conducted at King Khalid hospital in Tabuk city, Saudi Arabia, in the radiology department, in the period from September 2018 to April 2020. The study was done by collecting 471 CT reports of patients all of them were exposed to head trauma with deferent reasons. The data were analyzed by Statistical Package for the Social Sciences (SPSS) program (ver. 20) and presented in tables and graphs according to the checklist which includes: patient age, gender, type of trauma, CT finding, and type of hemorrhage. Results: The most age group suffered from head trauma was less than 20 years percentage (55%), The male patients more exposed to head trauma than female patients with percentage (84.5%), the road traffic accident (RTA) is the most common type of trauma by percentage (63.5%), according to the CT finding; the cerebral hemorrhage represented (15.5%) with the highest percentage in a subdural hematoma (31.2%), the fracture represented (2.8%) while the normal appearance represented (81.7%) as the highest percentage. Conclusion: Most of the traumatic brain injury in patients caused cerebral hemorrhage and the CT scan reports show that: the common type of cerebral hemorrhage is subdural hematoma and it is common in males which exposed to (RTA) in the age group (21 - 40) years old.

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