Dynamic research of serum cryptococcal capsular polysaccharide antigen test and chest CT of pulmonary cryptococcosis without HIV

Abstract

Objective and Methods: To observe the dynamic change of serum CrAg titer and chest CT of pulmonary cryptococcosis(PC) after treatment. A retrospective study was performed from January 2015 to April 2018. Results: Eighty-two patients with PC including 46 male (56.1%) were enrolled. Fifty-two (63.4%) patients were proven PC. Forty-five(54.9%) patients had underlying disease. Fifty-four (65.9%) patients were immunocompetent hosts. The mean duration of treatment was (7.89±2.40)months and the mean follow-up was (24±10)months. Improvement (>75%) in chest CT were found in 64.8% of the cases in immunocompetent group and 67.9% in immunocompromised group after 6 months’ treatment. Improvement (>75%) was found in 88.9% of the cases with patchy infiltrates or consolidation in Chest CT and 63% in nodular or mass-like type and mixed patterns of PC after 6 months’ treatment. The serum CrAg titer ranged from 1:4 to 1:160 before treatment (median 1:40) and decreased for all cases after antifungal treatment. Mean time which serum CrAg titer from positive to negative was (9.67±6.57) months. The serum CrAg titer became negative or decreased to 1:1 in 24 cases when treatment cessation, of whom the serum CrAg titer ranged from 1:5 to 1:160 before treatment (median 1:20). The serum CrAg titer of 31 cases ranged from 1:4 to 1:640 before treatment(median 1:64), after 6 months’ therapy, serum CrAg detection still positive, and CrAg titer was 1:10(range from 1:2 to 1:160). Conclusions: Serum CrAg titer decreased and chest CT improved after antifungal treatment in majiority PC cases. Infiltrates or consolidation pattern of PC was resolved fast than nodule and mixed pattern in CT.