Pulmonary Cryptococcosis: comparison of Cryptococcal antigen detection and radiography in Immunocompetent and Immunocompromised patients

Jingqi Min,Tao Zhu,Laifu Li,Kunlun Huang,Chanmei Shi,Fuye Li,Huojin Deng

doi:10.1186/s12879-020-4818-1

Abstract

BackgroundWe compared the cryptococcal antigen detection and imaging findings between immunocompetent and immunocompromised patients in whom pulmonary cryptococcosis had been diagnosed. The aim of our study was to determine whether the patient’s immune status and radiography affect the detection of cryptococcal antigen.MethodsAccording to whether they took immunosuppressive drugs or not, seventy and eight adult patients with pulmonary cryptococcosis were divided into two groups: the immunocompetent group and the immunocompromised group. According to the detection of CrAg, each group was divided into the CrAg+ group and the CrAg- group. Then, clinical records, laboratory examinations and computed tomography findings were collected and analyzed.ResultsNo difference was found in baseline characteristics, clinical symptoms, and laboratory investigations. By comparing CrAg detection in these two groups, it was found that the number of CrAg+ cases in the immunocompetent group was more than that in the immunocompromised group. And in the immunocompetent group, diffuse lesions were more common in CrAg+ group and limited lesions were more frequently observed in CrAg- group.ConclusionsThe patient’s immune status and radiography would affect the detection of cryptococcal antigen. And serum CrAg could be a useful tool for the diagnosis of pulmonary cryptococcosis in immunocompetent patients with extensive lung involvement.

Highlights

We compared the cryptococcal antigen detection and imaging findings between immunocompetent and immunocompromised patients in whom pulmonary cryptococcosis had been diagnosed
The data and information were collected: (1) demographic features and past medical history; (2) clinical features and symptoms; (3) laboratory tests, including white blood cell (WBC) counts, neutrophils counts, lymphocytes counts, concentrations of hemoglobin (Hb), platelet counts (PLT); (4) serum cryptococcal antigen (CrAg) was detected by lateral flow assay (LFA) (IMMY, Norman, OK, USA); (5) chest radiological findings [Fig. 1]
There was no significant difference in the levels of WBC, neutrophils, lymphocytes, Hb and PLT between two groups (Table 2)

Summary

Introduction

We compared the cryptococcal antigen detection and imaging findings between immunocompetent and immunocompromised patients in whom pulmonary cryptococcosis had been diagnosed. The aim of our study was to determine whether the patient’s immune status and radiography affect the detection of cryptococcal antigen. Cryptococcus complexes is very common in immunocompromised individuals, and it has become an emerging disease in immunocompetent ones [1,2,3]. Some reports have shown that pulmonary cryptococcosis occurs more frequently in immunocompetent patients than in immunocompromised ones [4, 5]. (because the incidence of AIDS in China is relatively low, so it will not be discussed here.) Considering the above information, we want to figure out whether the pulmonary radiography and immune status could affect the CrAg detection In a large number of clinical observations, we found that the immune status will have an impact on their detection. (because the incidence of AIDS in China is relatively low, so it will not be discussed here.) Considering the above information, we want to figure out whether the pulmonary radiography and immune status could affect the CrAg detection

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Conclusion