Rapidly progressive pneumonia caused by Cryptococcus neoformans in the patient of granulomatosis with polyangiitis

Akihiko Nakabayashi; Masafumi Seki; Toru Hirano; Haruhiko Hirata; Kazunori Tomono; Atsushi Kumanogoh

doi:10.1016/j.rmcr.2014.07.004

Rapidly progressive pneumonia caused by Cryptococcus neoformans in the patient of granulomatosis with polyangiitis

Respir Med Case Rep. 2014 Aug 8:13:13-5. doi: 10.1016/j.rmcr.2014.07.004. eCollection 2014.

Authors

Akihiko Nakabayashi¹, Masafumi Seki², Toru Hirano¹, Haruhiko Hirata¹, Kazunori Tomono², Atsushi Kumanogoh¹

Affiliations

¹ Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan.
² Division of Infection Control and Prevention, Osaka University, Suita City, Osaka, Japan.

Abstract

A 57-year-old male who had been treated for granulomatosis with polyangiitis (GPA) presented with cough and back pain that had persisted for three days. Mild infiltration shadows and nodules were found on computed tomography images at that time. Increase of GPA lesions and/or bacterial pneumonia was initially suspected. However, serum Cryptococcus neoformans antigen was positive and the chest X-ray findings had worsened by the following day despite of appropriate antibiotic treatment. Thus, pneumonia due to C. neoformans was diagnosed because C. neoformans was also isolated blood and lung tissues, and he was treated with antifungal agents: L-AMB and 5-FC, and followed up by chest radiography on a daily basis.

Keywords: Anti-fungal drugs; Cryptococcus neoformans antigen; Granulomatosis with polyangiitis; Opportunistic pathogen.