Cryptococcus Pneumonia in Immunocompetent Patient: A Case Report

免疫功能正常的病人感染隱球菌肺炎－個案報告

黃琛瑋(Chen-Wei Huang) ； 李明安(Ming-An Lee) ； 蔡正堅(Cheng-Ching Tsai) ； 彭惠琴(Hui-Chin Peng)

《北市醫學雜誌》 14卷4期 (2017/12) Pp. 522-527

https://doi.org/10.6200/TCMJ.2017.14.4.13

摘要

Cryptococcus pneumonia is caused by inhalation of the spores of crytpococcus neoformans. The pneumonia may be symptomatic or asymptomatic. Immune status is the most important factor that affects subsequent courses of the infection (resolves or progresses). We report a case of 62-year-old man, who was admitted to Zhongxing Branch of Taipei City Hospital, Taiwan because of 2 months persistent cough. Chest radiograph examination revealed left upper lobe (LUL) and left lower lobe (LLL) consolidations. Hemogram revealed no leukocytosis. Sputum acid fast stain was negative. Blood cryptococcus antigen titer was 1:128. Subsequent lung pathologic examination demonstrated granulomatous inflammation with yeast identified compatible with cryptococcus infection. After fluconazole treatment, the patient’s symptoms resolved and the chest imaging indicated improvement.

關鍵字

Cryptococcus pneumonia ； immune ； infection

並列摘要

隱球菌肺炎是由吸入隱球菌孢子所引起。此類肺炎有可能是有症狀的或無症狀的。免疫狀態是影響後續病程變化最重要的因素（緩解或惡化）。我們報告一個病例是一位六十二歲男性，因為咳嗽兩個月住進台北市立聯合醫院中興院區。胸部X 光顯示左上肺及左下肺實質化病灶。患者抽血檢查顯示並無白血球升高現象。痰液結核菌抹片為陰性。血液隱球菌抗原為陽性1:128 倍。之後肺臟病理切片顯示肉芽腫發炎反應並發現隱球菌感染。給予抗黴菌藥後病患的症狀及胸部X光皆有改善。

並列關鍵字

隱球菌肺炎 ； 免疫 ； 感染