Objective To investigate clinical characteristics of community acquired pulmonary crypyococcosis（PC）.Methods A total of 30 cases of PC diagnosed at Zhongshan Hospital of Fudan University from Jan 2003 to Dec 2007 were retrospectively analysed.All cases were identified by pathological study.Results The patients consisted of 19 males and 11 females，with median age of 44 years（16 to 70 years），66.7% of whom without underlying deseases and with normal immune function.9 patients（30%） were asymptomatic，and 21 patients（70%） had respiratory and/or constitutional symptoms.The most common symptoms were dry cough（16.7%），expectoration（46.7%），fever（23.3%），chest pain（13.3%） and dyspnea on exertion（13.3%）.All symptoms were mild and often showed a self-limiting trend.The common imaging features were nodule and mass，either solitary or multiple（53.3%），infiltrates and consolidation（40%） or diffused and mixed lesions.Non-caseous granulomas was the main character of patholgical study（96.7%），in which 93.1% with multinucleated giant cells containing abundant vacuolus yeast forms with the periodic acid schiff（PAS） reaction and/or Grocott Gomori’s methenamine silver（GMS） staining postive.Only one case found Cryptococcus neoformans spores in biopsy tissue smear and another in sputum smear.16.7% of the patients had positive biopsy tissue cultures for Cryptococcus neoformans，and 3.3% were positive of sputum cultures.15 patients underwent latex agglutination test for pulmonary cryptococcosis，and 93.3% were positive.Conclusions Some immunocompetent healthy people may compromised with community acquired PC with mild symptoms or even not at all and heterogeneous imaging appearance.Pathology，etiology，and serology were valuable diagnostic tools.
Citation： LIU Li ,HU Lijuan,ZHOU Yingying,ZHU Lei,HE Lixian. Clinical analysis of community acquired pulmonary cryptococcosis. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(5): 363-366. doi: Copy