Abstract
SummaryBackgroundPulmonary cryptococcosis (PC) is not considered an rare, opportunistic infection anymore. The immunocompetent population accounts for an increasing proportion of the morbidity.ObjectiveThis study investigated the clinical characteristics of PC patients spanning 20 years, in a referral centre of China.Patients/MethodsWe retrospectively investigated the clinical data of 99 patients with PC who were diagnosed at Peking Union Medical College Hospital (PUMCH) from January 1998 to December 2017.ResultsPulmonary cryptococcosis incidence in PUMCH has seen sharp increase in two decades. There were 40.4% (40/99), 17.2% (17/99) and 42.4% (42/99) immunocompetent, mildly immunocompromised and severe immunocompromised patients, respectively. Significantly higher (P = .035) male predominance in immunocompetent and mildly immunocompromised groups (68.4%, 39/57) compared with severe immunocompromised group (45.2%, 19/42) was found. Overall, 27.5% (11/40) immunocompetent patients reported a significant difference (P = .02) in history of more than weekly drinking, higher than mildly or severe immunocompromised. No significant difference occurred in symptoms and radiographic characteristics among the groups. In pulmonary computerised tomography findings, the non‐air pathway feature was the dominant distribution characteristics in all patients with PC (P = .002). The gap in body dissemination frequency between immunocompetent combined with mildly immunocompromised (5.26%, 3/57) and severe immunocompromised (19.0%, 8/42) was marginally significant (P = .05).ConclusionsGender and alcohol drinking could be PC risk factors of concern in patients without severe immunodeficiency. No significant difference occurred in symptoms or radiographic characteristics between patients with different levels of immune status. The unique radiographic non‐air pathway distribution in the lung may be the feature of Cryptococcus invasion that may enhance accurate diagnosis.
Highlights
The most common clinical manifestation of Cryptococcosis is the pulmonary system infection.[1]
A retrospective re‐ view of non‐acquired immunodeficiency syndrome (AIDS) patients pathologically diagnosed with pulmonary cryptococcosis (PC) from China revealed that 60% of PC cases were diagnosed in immuno‐ competent non‐human immunodeficiency virus (HIV) patients.[4]
We retrospectively reviewed the medical records of 116 hospital‐ ised patients who were diagnosed with ‘PC’ from January 1998 to December 2017 in Peking Union Medical College Hospital (PUMCH), the most authoritative referral centre in the Chinese hospital rank‐ ings of Fudan University
Summary
The most common clinical manifestation of Cryptococcosis is the pulmonary system infection.[1]. The prevalence of cryptococcosis in non‐HIV patients especially in non‐HIV non‐immunocompromised patients and the mechanism of the interaction between host and pathogen are being given increasing attention.[5,6]
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