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 vs53.31±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 vs16.08±16.41mm/h, P < 0.01), C-reactive protein (CRP) level (18.20±25.02 mg/L vs6.35±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 vs1.08±0.81, P < 0.01) were higher. There were no significant differencesBP( 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.
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