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Cryptococcal pneumonia in AIDS: is cryptococcal meningitis preceded by clinically recognizable pneumonia?
J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jun 01; 9(2):168-71.JA

Abstract

Identification of cryptococcal infection while it is still in its pulmonary phase might improve the prognosis for patients with AIDS who contract cryptococcosis. Since cryptococcal pneumonia is infrequently diagnosed in the AIDS patient, especially compared with the frequency of diagnosis of cryptococcal meningitis, this retrospective study was designed to investigate the frequency of pulmonary complaints in the months before diagnosis of cryptococcal meningitis. The medical records of 18 patients diagnosed with cryptococcal meningitis were analyzed. Of 18 patients, 14 (78%) had respiratory symptoms during the 4-month period before meningitis appeared, as compared with nine of 18 (50%) at the time of diagnosis and four of 16 (25%) in the 4 months following diagnosis. Seven of the 14 cases of pulmonary disease prediagnosis were of unknown etiology; three were eventually diagnosed as cryptococcal infections during evaluation of the meningitis. The remaining eight infections were attributed to bacteria, respiratory viruses, or Pneumocystis carinii, although three of these cultures also contained yeast, presumed to be Candida species, which were not further examined. Our data suggest the importance of singling out AIDS patients who may have pulmonary cryptococcosis. Cryptocococcsis should be included in the differential diagnosis of pulmonary infection in HIV-positive patients with CD4+ lymphocyte counts < 200/mm3, and full identification of yeasts recovered from sputum or bronchoalveolar lavage fluid cultures should be done. A larger study should be undertaken to better define the incidence of clinically recognizable pulmonary cryptococcosis in AIDS patients.

Authors+Show Affiliations

Driver JA
Evans Memorial Department of Clinical Research, Boston University Medical Center Hospital, MA 02118, USA.
Saunders CA
No affiliation info available
Heinze-Lacey B
No affiliation info available
Sugar AM
No affiliation info available

MeSH

AIDS-Related Opportunistic InfectionsCryptococcosisCryptococcus neoformansDiagnosis, DifferentialHumansIncidenceLung Diseases, FungalMaleMeningitis, CryptococcalPneumoniaRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

7749794

Citation

Driver, J A., et al. "Cryptococcal Pneumonia in AIDS: Is Cryptococcal Meningitis Preceded By Clinically Recognizable Pneumonia?" Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association, vol. 9, no. 2, 1995, pp. 168-71.
Driver JA, Saunders CA, Heinze-Lacey B, et al. Cryptococcal pneumonia in AIDS: is cryptococcal meningitis preceded by clinically recognizable pneumonia? J Acquir Immune Defic Syndr Hum Retrovirol. 1995;9(2):168-71.
Driver, J. A., Saunders, C. A., Heinze-Lacey, B., & Sugar, A. M. (1995). Cryptococcal pneumonia in AIDS: is cryptococcal meningitis preceded by clinically recognizable pneumonia? Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology : Official Publication of the International Retrovirology Association, 9(2), 168-71.
Driver JA, et al. Cryptococcal Pneumonia in AIDS: Is Cryptococcal Meningitis Preceded By Clinically Recognizable Pneumonia. J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jun 1;9(2):168-71. PubMed PMID: 7749794.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cryptococcal pneumonia in AIDS: is cryptococcal meningitis preceded by clinically recognizable pneumonia? AU - Driver,J A, AU - Saunders,C A, AU - Heinze-Lacey,B, AU - Sugar,A M, PY - 1995/6/1/pubmed PY - 1995/6/1/medline PY - 1995/6/1/entrez SP - 168 EP - 71 JF - Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association JO - J Acquir Immune Defic Syndr Hum Retrovirol VL - 9 IS - 2 N2 - Identification of cryptococcal infection while it is still in its pulmonary phase might improve the prognosis for patients with AIDS who contract cryptococcosis. Since cryptococcal pneumonia is infrequently diagnosed in the AIDS patient, especially compared with the frequency of diagnosis of cryptococcal meningitis, this retrospective study was designed to investigate the frequency of pulmonary complaints in the months before diagnosis of cryptococcal meningitis. The medical records of 18 patients diagnosed with cryptococcal meningitis were analyzed. Of 18 patients, 14 (78%) had respiratory symptoms during the 4-month period before meningitis appeared, as compared with nine of 18 (50%) at the time of diagnosis and four of 16 (25%) in the 4 months following diagnosis. Seven of the 14 cases of pulmonary disease prediagnosis were of unknown etiology; three were eventually diagnosed as cryptococcal infections during evaluation of the meningitis. The remaining eight infections were attributed to bacteria, respiratory viruses, or Pneumocystis carinii, although three of these cultures also contained yeast, presumed to be Candida species, which were not further examined. Our data suggest the importance of singling out AIDS patients who may have pulmonary cryptococcosis. Cryptocococcsis should be included in the differential diagnosis of pulmonary infection in HIV-positive patients with CD4+ lymphocyte counts < 200/mm3, and full identification of yeasts recovered from sputum or bronchoalveolar lavage fluid cultures should be done. A larger study should be undertaken to better define the incidence of clinically recognizable pulmonary cryptococcosis in AIDS patients. SN - 1077-9450 UR - https://www.unboundmedicine.com/medline/citation/7749794/Cryptococcal_pneumonia_in_AIDS:_is_cryptococcal_meningitis_preceded_by_clinically_recognizable_pneumonia L2 - http://www.diseaseinfosearch.org/result/279 DB - PRIME DP - Unbound Medicine ER -