Disseminated cryptococcosis with multiple and mediastinal lymph node enlargement and lung involvement in an immunocompetent child.

International journal of physiology, pathophysiology and pharmacology Pub Date : 2019-12-15 eCollection Date: 2019-01-01
Jun Chen, Meng-Jie Zhang, Xu-Hua Ge, Yan-Hua Liu, Tao Jiang, Jun Li, Zhuo Li, Hong-Jun Miao, Jun Yang
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Abstract

Background: Disseminated cryptococcosis is less common in individuals with normal immune function. Most cases occur in HIV-infected people. Usually it affects the lungs, followed by the central nervous system (CNS), skin and bone marrow, but rarely to the lymph nodes and chest wall.

Case presentation: This article reports a case of cryptococcal infection diagnosed as "lymphoma?" in a local hospital. It was characterized by chronic fever, weight loss, neck, axillary and inguinal lymph nodes enlargement, mediastinal and parabronchial lymphadenopathy, multiple nodular high-density images of both lungs, multi-serosal effusion, liver enlargement and other presentations.

Conclusions: Disseminated cryptococcosis can occur in immunocompromised children without HIV infection. This case of multiple and mediastinal lymphadenopathy, easily misdiagnosed as "lymphoma", requires high clinical suspicion and early initiation of treatment to effectively identify and treat patients.

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免疫功能正常儿童播散性隐球菌病伴多发纵隔淋巴结肿大及肺部受累。
背景:播散性隐球菌病在免疫功能正常的个体中较少见。大多数病例发生在艾滋病毒感染者中。它通常影响肺部,其次是中枢神经系统(CNS)、皮肤和骨髓,但很少影响淋巴结和胸壁。病例介绍:本文报告一例隐球菌感染在当地医院诊断为“淋巴瘤”。以慢性发热、体重减轻、颈部、腋窝及腹股沟淋巴结肿大、纵隔及支气管旁淋巴结肿大、双肺多发结节性高密度影像、多发浆膜积液、肝脏肿大等表现为特征。结论:播散性隐球菌病可发生在无HIV感染的免疫功能低下儿童中。本病例为多发纵隔淋巴结病,易误诊为“淋巴瘤”,需要临床高度怀疑,及早开始治疗,才能有效识别和治疗患者。
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