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A Case of Miliary Pulmonary Cryptococcosis and Review of Literature

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Abstract

We describe a case of cryptococcal fungemia in a 62-year-old male renal transplant patient. The diagnosis was established by isolation of Cryptococcus neoformans using the Isolator® blood culture lysis-centrifugation system. Testing for cryptococcal antigens was negative in the serum and cerebrospinal fluid. Transbronchial lung biopsies and bronchoalveolar lavage were negative. Antifungal therapy with fluconazole was started, resulting in fever remission, and a sustained clinical response was achieved. The literature on miliary pulmonary cryptococcosis is reviewed, and three similar cases were previously reported with disseminated cryptococcosis that resembled miliary tuberculosis on imaging. These emphasize the importance of eliminating causes other than tuberculosis in patients presenting with miliary pulmonary disease, even in countries with a high prevalence of tuberculosis.

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Authors and Affiliations

  1. Laboratório de Micologia, Hospital Santa Rita, Irmandade Santa Casa de Misericórdia Porto Alegre (ISCMPA), Annes Dias 285, Porto Alegre, RS, 90020-090, Brazil

    Cecília Bittencourt Severo, Flávio de Mattos Oliveira & Luiz Carlos Severo

  2. Clinical Medicine Department, Universidade Federal das Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil

    Rosana Mussoin Bruno

  3. Nefrology Department, ISCMPA, Porto Alegre, Brazil

    Rosana Mussoin Bruno

  4. Pneumology Department, ISCMPA, UFCSPA, Porto Alegre, Brazil

    Paulo Zimmermann Teixeira

  5. Radiology Department, ISCMPA, UFCSPA, Porto Alegre, Brazil

    Bruno Hochhegger

  6. Internal Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil

    Luiz Carlos Severo

Authors
  1. Cecília Bittencourt Severo
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  2. Rosana Mussoin Bruno
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  3. Flávio de Mattos Oliveira
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  4. Paulo Zimmermann Teixeira
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  5. Bruno Hochhegger
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  6. Luiz Carlos Severo
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Corresponding author

Correspondence to Luiz Carlos Severo.

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Severo, C.B., Bruno, R.M., de Mattos Oliveira, F. et al. A Case of Miliary Pulmonary Cryptococcosis and Review of Literature. Mycopathologia 179, 313–315 (2015). https://doi.org/10.1007/s11046-014-9853-2

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  • DOI: https://doi.org/10.1007/s11046-014-9853-2

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