[Clinical problems in medical mycology: Problem number 46.]

Revista iberoamericana de micologia : organo de la Asociacion Espanola de Especialistas en Micologia

PubMedID: 23462234

Negroni R, Arechavala A, Santiso G, BonvehĂ­ P. [Clinical problems in medical mycology: Problem number 46.]. Rev Iberoam Micol. 2013;.
A 49 year old-man, without known previous diseases, who suffer an acute lung infection is presented. He was a smoker and belonged to a high socioeconomic class. He suddenly presented high fever, dry cough and legs' pain. Thorax X-ray and CT scan showed 2 excavated pneumonic infiltrates in the lower part of the right lung. He was treated with antibacterial antibiotics without clinical response. A transparietal fine needle lung biopsy was performed and the histopathology and cytological studies presented an epithelioid granuloma with capsulated yeasts. Cryptococcus neoformans antigenemia was positive 1/128, and brain MR, as well as CSF studies, allowed to rule out a central nervous system compromise. The patient was successfully treated with itraconazole by oral route at a daily dose of 400mg during 6 months. Post-treatment thorax CT scan showed a thin walled lung cavity as a sequela.