Isolated Pleural Cryptococcosis in an Immunocompetent Patient-A Case Report

新型隱球菌單純只有在肋膜感染是很少見的，通常在合併有胸水發生的新型隱球菌感染的情況下，常是有肺實質的感染，常可見以肺結節、月市浸潤或肋膜下的結節來表現，間接說明胸水的致病機轉，可能是由肋膜下的病灶直接散佈而來。在免疫力低下的病人，若有胸水發生的新型隱球菌感染，同常表示有散播性的全身感染，而在正常免疫力的病人發生新型隱球菌的感染，很少發生胸水。我們在此提出單純肋膜感染合併胸水，而無肺實質感染新型隱球菌的病歷報告。一個53歲的男性，因為胸痛、喘而到胸腔內科求診，胸部X光片檢查顯示左肋膜腔積水，胸部電腦斷層顯示無肺實質病灶，經肋膜切片證實為新型隱球茵感染。

關鍵字

新型隱球菌；肋膜腔積水；免疫力正常；膿胸

並列摘要

Pleural effusion is an unusual manifestation of cryptococcal infection, and when it does occur, it is almost always accompanied by pulmonary parenchymal disease, usually in the form of infiltrates or nodules. A subpleural nodule is often found immediately subjacent to the effusion, suggesting that the pathogenesis of such an effusion involves direct spread from the subpleural focus. Pleural effusion occasionally occurs in immunocompromised patients with cryptococcosis and suggested disseminated disease. In hosts with a normal immune status and cryptococcosis, pleural effusion is rarely seen. We report a case of isolated pleural involvement by cryptococcus in an immuncompetent patient. A 53-year-old male suffered from chest pain and dyspnea for 1 week. Chest X-ray on presentation showed left-side pleural effusion, and chest CT revealed a small amount of fluid in the left pleural space. There were no pulmonary parenchymal lesions. The pleural biopsy revealed cryptococcosis and chronic granulomatous inflammation.

並列關鍵字

Cryptococcus neoformans ； pleural effusion ； empyema ； immunocompetent

國際替代計量

Isolated Pleural Cryptococcosis in an Immunocompetent Patient-A Case Report

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