Clinical and imaging characteristics of pulmonary cryptococcosis: a comparative analysis of 118 non-AIDS patients in China

Med Mycol. 2023 Mar 2;61(3):myad019. doi: 10.1093/mmy/myad019.

Abstract

The accurate diagnosis of pulmonary cryptococcosis (PC) is an important guarantee for the selection of reasonable treatment methods. In this paper, the clinical and imaging manifestations of PC in non-AIDS patients were retrospectively analyzed, and according to whether there was an underlying disease, a comparative analysis was carried out to deepen the understanding of PC, and improve the accuracy of its diagnosis. Both clinical and CT imaging data of 118 PC patients were analyzed retrospectively. The clinical manifestations of PC patients were not specific, and 61 patients had no apparent symptoms. A total of 49 patients (49/118) were treated with antifungal agents alone, 46 of them had follow-up records after treatment, and 91.3% (42/46) of them achieved a good outcome. The most common imaging sign was the subpleural nodule or mass. Other main imaging signs include bronchial air sign (50/118), halo sign (32/118), ring target sign (65/118), lobulation sign (72/118), and necrosis (76/118). In terms of age, halo sign, and ring target sign, there were significant differences between the group with underlying disease and the group without underlying disease (P < .05). The CT manifestations of PC have some characteristics, and using antifungal agents can achieve good outcomes.

Keywords: AIDS; clinical manifestations; comparative analysis; imaging; pulmonary cryptococcosis.

Plain language summary

The CT manifestations of PC were characteristic. The subpleural lesions combined with bronchial air sign, ring target sign, and necrosis were important for the accurate diagnosis of PC. In addition, antifungal therapy for PC patients can achieve good results.

MeSH terms

  • Animals
  • Antifungal Agents / therapeutic use
  • China
  • Cryptococcosis* / diagnostic imaging
  • Cryptococcosis* / veterinary
  • Retrospective Studies
  • Tomography, X-Ray Computed* / methods

Substances

  • Antifungal Agents