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Reference Manager
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-
1.
Hou X , Kou L , Han X , Zhu R , Song L , Liu T , 2019. Pulmonary cryptococcosis characteristics in immunocompetent patients—a 20-year clinical retrospective analysis in China. Mycoses 62: 937–944.
-
2.
Li Y et al.2017. Cryptococcosis in patients with diabetes mellitus II in mainland China: 1993–2015. Mycoses 60: 706–713.
-
3.
Jarvis JN , Harrison TS , 2008. Pulmonary cryptococcosis. Semin Respir Crit Care Med 29: 141–150.
-
4.
Aslam HM et al.2018. An unusual case of pulmonary Cryptococcus. Cureus 10: e3707.
-
5.
Setianingrum F , Rautemaa-Richardson R , Denning DW , 2019. Pulmonary cryptococcosis: a review of pathobiology and clinical aspects. Med Mycol 57: 133–150.
-
6.
Alvarez M , Casadevall A , 2006. Phagosome extrusion and host-cell survival after Cryptococcus neoformans phagocytosis by macrophages. Curr Biol 16: 2161–2165.
-
7.
Feldmesser M , Tucker S , Casadevall A , 2001. Intracellular parasitism of macrophages by Cryptococcus neoformans. Trends Microbiol 9: 273–278.
-
8.
Steenbergen JN , Casadevall A , 2003. The origin and maintenance of virulence for the human pathogenic fungus Cryptococcus neoformans. Microbes Infect 5: 667–675.
-
9.
Normile TG , Bryan AM , Del Poeta M , 2020. Animal models of Cryptococcus neoformans in identifying immune parameters associated with primary infection and reactivation of latent infection. Front Immunol 11: 581750.
-
10.
Odds FC , De Backer T , Dams G , Vranckx L , Woestenborghs F , 1995. Oxygen as limiting nutrient for growth of Cryptococcus neoformans. J Clin Microbiol 33: 995–997.
-
11.
Bianchi-de-Aguiar F , Campanha R , Guimarães C , Simões-Raposo M , 2018. Pulmonary tuberculosis reactivation: triggered by the descent in altitude? Acta Med Port 31: 589–592.
-
12.
Huerta-Sánchez E , Casey FP , 2015. Archaic inheritance: supporting high-altitude life in Tibet. J Appl Physiol 119: 1129–1134.
-
13.
Lindell RM , Hartman TE , Nadrous HF , Ryu JH , 2005. Pulmonary cryptococcosis: CT findings in immunocompetent patients. Radiology 236: 326–331.
-
14.
Fox DL , Müller NL , 2005. Pulmonary cryptococcosis in immunocompetent patients: CT findings in 12 patients. AJR Am J Roentgenol 185: 622–626.
-
15.
Khoury MB , Godwin JD , Ravin CE , Gallis HA , Halvorsen RA , Putman CE , 1984. Thoracic cryptococcosis: immunologic competence and radiologic appearance. AJR Am J Roentgenol 142: 893–896.
-
16.
Cheng KB , Wu ZH , Liang S , Li HP , Xu JF , 2021. Associations of serum cryptococcal antigen with different of clinical characteristics: a comprehensive analysis of 378 pulmonary cryptococcosis patients. Ann Palliat Med 10: 681–693..
-
17.
Perfect JR et al.2010. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america. Clin Infect Dis 50: 291–322.
-
18.
Fisher JF , Valencia-Rey PA , Davis WB , 2016. Pulmonary cryptococcosis in the immunocompetent patient-many questions, some answers. Open Forum Infect Dis 3: ofw167.
| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 1836 | 972 | 40 |
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Case Report: A Great Mimicker of Neoplasm: Pulmonary Cryptococcosis in an Immunocompetent Host After High-Altitude Descent
Keely Johnson
Keely Johnson
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, New York;
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Umaima Dhamrah
Umaima Dhamrah
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, New York;
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Aisha Amin
Aisha Amin
Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, New York;
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Joseph Masci
Joseph Masci
Department of Infectious Diseases, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, New York
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ABSTRACT.
Cryptococcus exposure in certain global regions is common and yet virulence in the immunocompetent host remains rare. Radiological findings of pulmonary cryptococcosis may include nonspecific lung nodules or masses indistinguishable from lung cancer or pulmonary tuberculosis. We present a case of an immunocompetent diabetic female who presented with progressively worsening pleuritic chest pain and cough with travel between Tibet and New York 2 months earlier. Chest imaging demonstrated a large lobulated mass, acid-fast bacillus smears were negative, and our patient underwent pulmonary biopsy, which grew rare budding yeast later confirmed by mucicarmine staining as Cryptococcus. Our patient was successfully treated with fluconazole therapy. We hypothesize that the high altitude of Tibet may allow for clinical latency followed by symptomatic reactivation on descent. A raised index of suspicion for pulmonary cryptococcosis with careful attention to travel history is expected to facilitate timely diagnosis.
Author Notes
Authors’ addresses: Keely Johnson, Umaima Dhamrah, and Aisha Amin, Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, NY, E-mails: keelyjohnsonmd@gmail.com, dhamrahumaima@gmail.com, and aisha.aminh@gmail.com. Joseph Masci, Department of Infectious Diseases, Icahn School of Medicine at Mount Sinai, Elmhurst Hospital Center, Elmhurst, NY, E-mail: mascij@nychhc.org.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Hou X , Kou L , Han X , Zhu R , Song L , Liu T , 2019. Pulmonary cryptococcosis characteristics in immunocompetent patients—a 20-year clinical retrospective analysis in China. Mycoses 62: 937–944.
-
2.
Li Y et al.2017. Cryptococcosis in patients with diabetes mellitus II in mainland China: 1993–2015. Mycoses 60: 706–713.
-
3.
Jarvis JN , Harrison TS , 2008. Pulmonary cryptococcosis. Semin Respir Crit Care Med 29: 141–150.
-
4.
Aslam HM et al.2018. An unusual case of pulmonary Cryptococcus. Cureus 10: e3707.
-
5.
Setianingrum F , Rautemaa-Richardson R , Denning DW , 2019. Pulmonary cryptococcosis: a review of pathobiology and clinical aspects. Med Mycol 57: 133–150.
-
6.
Alvarez M , Casadevall A , 2006. Phagosome extrusion and host-cell survival after Cryptococcus neoformans phagocytosis by macrophages. Curr Biol 16: 2161–2165.
-
7.
Feldmesser M , Tucker S , Casadevall A , 2001. Intracellular parasitism of macrophages by Cryptococcus neoformans. Trends Microbiol 9: 273–278.
-
8.
Steenbergen JN , Casadevall A , 2003. The origin and maintenance of virulence for the human pathogenic fungus Cryptococcus neoformans. Microbes Infect 5: 667–675.
-
9.
Normile TG , Bryan AM , Del Poeta M , 2020. Animal models of Cryptococcus neoformans in identifying immune parameters associated with primary infection and reactivation of latent infection. Front Immunol 11: 581750.
-
10.
Odds FC , De Backer T , Dams G , Vranckx L , Woestenborghs F , 1995. Oxygen as limiting nutrient for growth of Cryptococcus neoformans. J Clin Microbiol 33: 995–997.
-
11.
Bianchi-de-Aguiar F , Campanha R , Guimarães C , Simões-Raposo M , 2018. Pulmonary tuberculosis reactivation: triggered by the descent in altitude? Acta Med Port 31: 589–592.
-
12.
Huerta-Sánchez E , Casey FP , 2015. Archaic inheritance: supporting high-altitude life in Tibet. J Appl Physiol 119: 1129–1134.
-
13.
Lindell RM , Hartman TE , Nadrous HF , Ryu JH , 2005. Pulmonary cryptococcosis: CT findings in immunocompetent patients. Radiology 236: 326–331.
-
14.
Fox DL , Müller NL , 2005. Pulmonary cryptococcosis in immunocompetent patients: CT findings in 12 patients. AJR Am J Roentgenol 185: 622–626.
-
15.
Khoury MB , Godwin JD , Ravin CE , Gallis HA , Halvorsen RA , Putman CE , 1984. Thoracic cryptococcosis: immunologic competence and radiologic appearance. AJR Am J Roentgenol 142: 893–896.
-
16.
Cheng KB , Wu ZH , Liang S , Li HP , Xu JF , 2021. Associations of serum cryptococcal antigen with different of clinical characteristics: a comprehensive analysis of 378 pulmonary cryptococcosis patients. Ann Palliat Med 10: 681–693..
-
17.
Perfect JR et al.2010. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america. Clin Infect Dis 50: 291–322.
-
18.
Fisher JF , Valencia-Rey PA , Davis WB , 2016. Pulmonary cryptococcosis in the immunocompetent patient-many questions, some answers. Open Forum Infect Dis 3: ofw167.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 1836 | 972 | 40 |
| Full Text Views | 300 | 15 | 0 |
| PDF Downloads | 151 | 18 | 0 |