Clinical analysis of 18 pulmonary cryptococcosis cases

Objective To study the clinical features of pulmonary cryptococcosis in order to improve our understanding of the disease. Methods Clinical data about 18 patients with pulmonary cryptococcosis pathologically diagnosed in our hospital from January 2001 to August 2008 were retrospectively analyzed. Results Most of the cases were males at the age of 30 and 50 years. None of them had underlying diseases. The main clinical manifestations were cough, expectoration and fever. Chest CT mainly showed multiple nodular masses. The diagnosis was confirmed by CT guided transthoracic lung biopsy and operation in 7 and 11 cases, respectively. The misdiagnosis rate was 100% before its pathologic diagnosis. Of the 18 patients, 11 underwent surgical resection and 7 received anti-fungal agents, which achieved rather good results. Conclusion Pulmonary cryptococcosis usually occurs in males at the age of 30-50 years with no specific clinical manifestations. Chest CT mainly shows pulmonary nodular masses. Its misdiagnosis rate is high and its final diagnosis depends on pathologic examination which should be considered as early as possible for those whose diagnosis is difficult to make.