一位中年女性播散性隐球菌病的罕见表现

D. Pal, Avijit Das, Shekhar Pal, S. Chatterji, M. Ghosh, A. Naskar, S. Mallik, A. Chakrabarty
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引用次数: 0

摘要

隐球菌病是一种常见的机会性病原体,在晚期人类免疫缺陷病毒(HIV)感染的情况下,特别是CD4细胞计数低于50细胞/微升和其他免疫缺陷情况下,如血液恶性肿瘤、移植接受者或长期接受糖皮质激素和/或免疫抑制剂治疗的人。播散性隐球菌病在免疫正常人群中并不常见。我们在我们的研究所发现了这样一个病例,最初表现为肺部肿块病变,后来发展为慢性无法愈合的皮肤溃疡和无症状的大脑受累,但没有任何明显的免疫抑制证据。然而,患者在胸部出现症状一年半后发展为胆囊癌。她接受了手术切除,但术后未接受放疗和化疗。根据美国传染病学会(IDSA)指南,她成功地接受了抗真菌联合治疗。
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An Unusual Presentation of Disseminated Cryptococcosis in a Middle AgedFemale
Cryptococcosis is a common opportunistic pathogen in the setting of advanced human immunodeficiency virus (HIV) infection especially with CD4 count less than 50 cells/micro liter and in other immunodeficient conditions such as hematologic malignancies, transplant recipients or in persons on prolonged glucocorticoid and/or immunosuppressant therapy. Disseminated cryptococcosis is uncommon in immunocompetent person. We detected such a case at our institute presented initially with pulmonary mass lesion and later evolving into chronic non-healing skin ulcer and asymptomatic brain involvement without having any evidence of overt immunosuppression. However the patient developed gall-bladder carcinoma about one and half years after her chest complaints. She underwent surgical resection but neither received radiotherapy nor chemotherapy post-surgery. She was treated successfully with anti-fungal combination therapy as per Infectious Diseases Society of America (IDSA) guideline.
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