Clinical features and CT analysis of 45 cases of pulmonary cryptococcosis in HIV-uninfected patients
Objective This study aims to explore the clinical and radiological characteristics of non-HIV-infected patients with pulmonary cryptococcosis in order to reduce missed diagnosis and misdiagnosis.Methods The clinical and imaging data of patients with pulmonary cryptococcosis diagnosed in our hospital from January 2021 to December 2023 were retrospective-ly analyzed.Results A total of 45 non-HIV-infected pulmonary cryptococcosis patients were included,including 22 males with an average age of 55.47±15.31 years old.There were 16 patients in the immunocompromised group,with an average age of 60.38±11.59 years old,which was significantly higher than the 33.34±9.53 years old in the immunocompromised group (P<0.0001).Asymptomatic patients accounted for 42.22％ (19 cases).High-resolution computed tomography (HRCT) showed that the lesions were mainly single nodules (34/45 cases),and the lesions were most frequently located in the lower lobe of the left lung (22 cases,accounting for 48.89％),followed by the lower lobe of the right lung.(15 cases,accounting for 33.33％) and the upper lobe of the right lung (11 cases,accounting for 24.44％).The positive rate of con-firmed diagnosis by histopathological examination of lung puncture under percutaneous CT guidance was 100％ (15/15 ca-ses).The positive rate of cryptococcal culture in lung tissue was 70％ (7/10 cases),which was higher than that in alveolar lavage fluid.Conclusion The clinical manifestations of non-HIV-infected pulmonary cryptococcosis lack specificity.For pa-tients with high clinical suspicion,percutaneous CT-guided lung puncture for lung tissue fungal culture and pathological ex-amination is recommended as the first choice.
万方数据
维普
