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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

Transient improvement of cryptococcal pneumonia by steroid therapy conducted under a diagnosis of organizing pneumonia: a case report

Naoko Katsurada  Hisashi Ohnishi  Satomi Yamamoto  Saori Kinami  Teruaki Nishiuma 

Department of Respiratory Medicine, Akashi Medical Center

ABSTRACT

A 68-year-old woman presented to her local hospital with dyspnea. She was on corticosteroid therapy for interstitial pneumonia of Sjögren's syndrome. Chest CT scan revealed multiple patchy consolidations in both lungs. Exacerbation of interstitial pneumonia was initially suspected, and intravenous steroid pulse therapy was performed followed by a temporal increase of oral steroid dosage. Her second chest CT showed improvement in consolidations, and her clinical symptom also improved. Two months later, she began to experience dyspnea again. Chest CT showed worsening of multiple patchy consolidations, and she was referred to our hospital. Based on the radiological findings and her clinical course, organizing pneumonia associated with Sjögren's syndrome was considered. However, yeast-like fungi in alveoli and histiocytes were obtained by transbronchial biopsy. The final diagnosis was made as pulmonary cryptococcosis. She also had meningitis and skin lesions, which were caused by Cryptococcus neoformans. All her symptoms improved after the antifungal therapy was started. The consolidation on CT scans was inferred to have improved temporally as a result of the acute inflammation of C. neoformans being suppressed by steroid therapy.

KEYWORDS

Pulmonary cryptococcosis  Steroid  Antifungal treatment 

Received 9 Mar 2011 / Accepted 3 Oct 2011

AJRS, 1(1): 14-19, 2012

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