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Medical Science Monitor Basic Research


Pulmonary Cryptococcosis in a Nurse Initially Suspected of Having Pulmonary Tuberculosis

Unusual clinical course, Mistake in diagnosis

Hidemi Ogawa, Takashi Urushibara, Hajime Kasai, Hideki Ikeda, Toshihide Shinozaki

Japan Department of Respiratory Medicine, Kimitsu Chuo Hospital, Kisarazu, Chiba, Japan

Am J Case Rep 2020; 21:e919267

DOI: 10.12659/AJCR.919267

Available online: 2020-01-11

Published: 2020-01-11


BACKGROUND: Pulmonary cryptococcosis can be associated with various imaging findings and can occur in immunocompetent hosts. It is sometimes difficult to distinguish pulmonary cryptococcosis from pulmonary tuberculosis based on imaging findings.
CASE REPORT: A 34-year-old female nurse who worked in an endoscopy examination room visited our hospital because of an abnormal lung shadow. At her workplace, a gastrointestinal endoscopy had been performed on a patient with infectious tuberculosis. The nurse was asymptomatic, and acid-fast staining and culture of her sputum were negative. Chest computed tomography depicted multiple nodules distributed along the bronchi. An acid-fast smear test of bronchial lavage was negative and cytological investigations revealed many yeast-like fungi. Fluconazole was administered and the computed tomography findings improved.
CONCLUSIONS: It is important to consider cryptococcosis, even in patients suspected of having tuberculosis.

Keywords: Bronchoscopy, Cryptococcosis, Tuberculosis, Pulmonary, Fungi, Unclassified