| Clinical characteristics of nodular and massive exudative pulmonary cryptococcosis |
| Received:September 14, 2021 Revised:October 05, 2021 Click here to download the full text |
| Citation of this paper:YAN Yu,LI Jiang-hong,WU Yu-xiao,WANG Qin,ZHU Xiao-dan,LI Hua-yin,JIANG Hong-ni.Clinical characteristics of nodular and massive exudative pulmonary cryptococcosis[J].Chinese Journal of Clinical Medicine,2021,28(6):969-973 |
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| Author Name | Affiliation | E-mail | | YAN Yu | Department of Respiration, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | LI Jiang-hong | Department of Respiration, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Department of Respiration, Xi'an International Medical Center Hospital, Xi'an 710100, Shaanxi, China | | | WU Yu-xiao | Department of Respiration, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | WANG Qin | Department of Respiration, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | ZHU Xiao-dan | Department of Respiration, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | LI Hua-yin | Department of Respiration, Zhongshan Hospital, Fudan University, Shanghai 200032, China | | | JIANG Hong-ni | Department of Respiration, Zhongshan Hospital, Fudan University, Shanghai 200032, China | jiang.hongni@zs-hospital.sh.cn |
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| Abstract:Objective: To explore the differences of clinical manifestations of pulmonary cryptococcosis (PC) patients with pulmonary CT manifestations of nodules or masses exudation, and to improve early diagnosis and identification of PC. Methods: Totally, 187 non-HIV-infected inpatients diagnosed with PC from January 1, 2010 to January 1, 2020 at Zhongshan Hospital, Fudan University were enrolled. Based on chest imaging manifestations, patients were divided into two groups:nodular group (n=121) and mass exudative group (n=66).[BP(]Basic information, medical history, laboratory results, chest CT images, and other relevant data were collected. Demographical and clinical characteristics were evaluated accordingly.[BP)]Relevant clinical data such as age, gender, underlying diseases, clinical symptoms, inflammation indicators, and cryptococcal capsular antigen (CrAg) were collected and analyzed of the 2 groups. Results: Compared with the nodular group, the age of onset in PC patients with mass exudation-based lesions was earlier ([46.61±15.35] years old vs[53.31±12.39] years old, P<0.01); cough (57.6% vs 35.5%, P<0.01), sputum (36.4% vs 17.4%, P<0.01), and fever (36.4% vs 11.6%, P<0.01) were more common; the erythrocyte sedimentation rate (ESR) ([28.34±24.11] mm/h vs[16.08±16.41]mm/h, P<0.01), C-reactive protein (CRP) level ([18.20±25.02] mg/L vs[6.35±12.71] mg/L, P<0.01], the incidence of lymphocytes less than 20% was higher (46.9% vs 25.4%, P< 0.01), the positive rate of cryptococcal capsular antigen (CrAg) (93.4% vs 81.3%, P<0.05), and the average titer of CrAg (expressed as -lg value,[2.01±0.93] vs[1.08±0.81], P<0.01) were higher. There were no significant differences[BP(] in the underlying diseases, use of systemic glucocorticoids or immunosuppressant agents,[BP)]in white blood cell count, neutrophil count, lymphocyte count, and procalcitonin between the two groups. Conclusions: Nodular lesions are the most common CT findings in non-HIV-infected PC patients. PC patients with mass exudative lesions accompany with higher incidence rate of fever, cough, and sputum, higher level of ESR, CRP, as well as higher titer of CrAg. |
| keywords:pulmonary cryptococcosis chest CT nodular-type mass exudative-type cryptococcal capsular antigen |
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