Organizing pneumonia secondary to pulmonary cryptococcosis in immunocompromised patient

Zentaro Saito; Takanori Ito; Takuma Imakita; Issei Oi; Osamu Kanai; Kohei Fujita

doi:10.1016/j.rmcr.2023.101975

Organizing pneumonia secondary to pulmonary cryptococcosis in immunocompromised patient

Respir Med Case Rep. 2023 Dec 29:47:101975. doi: 10.1016/j.rmcr.2023.101975. eCollection 2024.

Authors

Zentaro Saito¹, Takanori Ito¹, Takuma Imakita¹, Issei Oi¹, Osamu Kanai^{1

2}, Kohei Fujita^{1

2}

Affiliations

¹ Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
² Department of Infectious Diseases, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

Abstract

Pulmonary cryptococcal infections are fungal infections that often occur in immunocompromised patients and present with a variety of radiographic patterns ranging from nodular to infiltrative shadows. In the present case, we experienced a rare case of organizing pneumonia due to cryptococcal infection in a 71-year-old woman with rheumatoid arthritis. Transbronchial lung biopsy showing fibrotic changes in the alveolar walls, small granulation lesions and cryptococcal organisms with positive Grocott staining. Serum cryptococcal antigen was also found to be positive. Based on these findings, we confirmed the diagnosis of secondary organizing pneumonia due to cryptococcal infection. Treatment with corticosteroids and antifungal drugs led to improvement of the cough and reduction of organizing pneumonia. In immunocompetent patients with organizing pneumonia, it is essential to perform bronchoscopic lung biopsies and serum antigen tests to search for the cause, whenever possible, as it may be due to an infection caused by Cryptococcus, as in the present case.

Keywords: Cryptococcosis; Cryptococcus neoformans; Diabetes mellitus; Fungal disease; Immunocompromised host; Organizing pneumonia.

Publication types

Case Reports