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Abstract

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Article in Japanese

Case Report

A case of clinically diagnosed pulmonary cryptococcosis with Cushing’s syndrome

Tomoko Terada  Yoshihisa Nukui  Manabu Sema  Yu Kusaka  Tsukasa Okamoto  Naohiko Inase 

Department of Respiratory Medicine, Tokyo Medical and Dental University

ABSTRACT

There are limited reports of pulmonary cryptococcosis in patients with Cushing’s syndrome. We report the case of a 23-year-old woman with suspected Cushing’s syndrome. She underwent diagnostic imaging, with chest non-contrast computed tomography (CT) revealing a 7 mm irregular nodule. Sputum culture, sputum cytology, serum antigen levels of mycoses, and interferon-gamma release assays (IGRA) were negative. A chest non-contrast CT scan three weeks later revealed that the nodule had grown to 21 mm, and the cryptococcal antigen titer was now positive. The patient was diagnosed with pulmonary cryptococcosis and treated with fluconazole, which resulted in the disappearance of the nodule. Pulmonary cryptococcosis with Cushing’s syndrome is rare, and caution must be taken since serum cryptococcal antigen titers may be negative when the nodules on CT are small.

KEYWORDS

Pulmonary cryptococcosis  Cushing’s syndrome  Lung nodule  Serum cryptococcal antigen 

Received 8 Sep 2017 / Accepted 10 Nov 2017

AJRS, 7(1): 44-48, 2018

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