The Diagnostic Challenge of an Infrequent Spectrum of Cryptococcus Infection

Cryptococcal infection results from inhalation of fungal spores and usually is confined to the lungs, but may disseminate systemically. Radiologically, cryptococcal infection has multiple forms of presentation. The diagnosis is usually based on fungal isolation from cultured clinical specimens. Long...

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Published inCase reports in radiology Vol. 2019; no. 2019; pp. 1 - 6
Main Authors Durante, Henrique, Cintra Zagatti, Ricardo Francisco, Sawamura, Márcio Valente Yamada, Mendes Coura, Laura, Karine Veras Gomes De Mello, Rita, Gallotti Borges Carneiro, Stefanie, Wanderley, Mark, Alejandra Ortiz Navas, Daniela, Tambelini Gomes, Liege, Corona De Godoy Bueno, Camila, Barbosa De Araujo Neto, Francisco, Sayuri Missumi, Larissa
Format Journal Article
LanguageEnglish
Published Cairo, Egypt Hindawi Publishing Corporation 2019
Hindawi
Hindawi Limited
Wiley
Subjects
Antigens
Case Report
Case reports
Chest
Clinical medicine
Computed tomography
Computer simulation
Diagnosis
Diagnostic systems
Etiology
Fungal infections
Fungi
Fungicides
Histopathology
HIV
Human immunodeficiency virus
Infections
Infectious diseases
Lesions
Lungs
Lymphatic system
Medical imaging
Microorganisms
Pain
Pathogens
Patients
Respiration
Spores
Tuberculosis
Weight loss
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Summary:Cryptococcal infection results from inhalation of fungal spores and usually is confined to the lungs, but may disseminate systemically. Radiologically, cryptococcal infection has multiple forms of presentation. The diagnosis is usually based on fungal isolation from cultured clinical specimens. Long term antifungal therapy is recommended, but surgical procedures may eventually be necessary when large thoracic symptomatic masses are present. We report a case of a 41-year-old male, immunocompetent, investigating a palpable mass in the left supraclavicular region associated with unintentional weight loss over the last three months. He also reported chest pain in this period. Chest X-ray, ultrasonography, and computed tomography were performed, which diagnosed a mediastinal and left supraclavicular mass, interpreted as lymph node conglomerates of unknown etiology. He also underwent a biopsy of the left supraclavicular mass for etiological determination by histopathology, which confirmed cryptococcosis infection. Although very infrequent, mediastinal cryptococcal infection (simulating masses) is a challenging but important differential diagnosis of benign and malignant lesions, since its treatment is usually clinical.
Bibliography:Academic Editor: Daniel P. Link
ISSN:2090-6862
2090-6870
DOI:10.1155/2019/5970648