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Semin Respir Crit Care Med 2004; 25(2): 145-157
DOI: 10.1055/s-2004-824899
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Pulmonary Cryptococcosis

Olivier Lortholary1 , 2 , Hilario Nunez3 , Michel W. Brauner4 , Françoise Dromer2
  • 1Service des Maladies Infectieuses et Tropicales, Hôpital Necker, Paris, France
  • 2Centre National de Référence Mycologie et Antifongiques, Institut Pasteur, Paris, France
  • 3Service de Pneumologie, Hôpital Avicenne, Bobigny, France
  • 4Service de Radiologie, Hôpital Avicenne, Bobigny, France
Further Information

Publication History

Publication Date:
19 April 2004 (online)

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Pulmonary cryptococcosis is the consequence of the inhalation of Cryptococcus neoformans, an encapsulated yeast, from various environmental sources. It is commonly accepted that the acquisition of the disease occurs early in life and that the disease is mostly related to a reactivation from a pulmonary site in immunocompromised hosts such as patients infected with human immunodeficiency virus. Clinical and radiological presentations of the disease are nonspecific and are more severe in immunocompromised hosts with acquired immunodeficiency syndrome (AIDS). However, fulminant forms have also been reported in apparently immunocompetent hosts. C. neoformans has rarely been responsible for colonization of the respiratory tract; this usually occurs in immunocompetent hosts with preexisting pulmonary disease. Diagnosis of pneumonia is obtained by either analysis of bronchoalveolar lavage in AIDS patients or by the histology/mycological analysis of a pulmonary nodule. In any case, a careful work-up for diagnosing dissemination should always be performed. Antifungal treatment has to be given in most of the immunocompetent hosts and always in those with any kind of immunodeficiency with isolated pulmonary cryptococcosis.

KEYWORDS

Cryptococcus neoformans - pneumonia - AIDS - fluconazole

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Olivier LortholaryM.D. Ph.D. 

Centre National de Référence Mycologie et Antifongiques, Institut Pasteur, 25, rue du Dr Roux, 75015 Paris, France

Email: olortho@pasteur.fr

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