Pulmonary nodules: An unusual onset of HIV infection belatedly diagnosed |
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| Institution: | 1. Servicio de Microbiología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain;2. Servicio de Neumología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain;3. Servicio de Anatomía Patológica, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain;4. Departamento de Ciencias Clínicas, Área de Microbiología, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain;1. Jeonju AgroBio-Materials Institute, Jeonju-si, Republic of Korea;2. National Marine Biodiversity Institute of Korea, Seocheon-gun, Republic of Korea;1. Universidade Regional Integrada do Alto Uruguai e das Missões, Erechim, RS, Brazil;2. Universidade Federal do Rio Grande do Sul, Programa de Pós-graduação em Ciências Farmacêuticas, Porto Alegre, Brazil;3. Clínica Médica, Erechim, Brazil;4. Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil;5. Clínica Médica, Palmeira das Missões, Brazil;1. Departamento de Química de Biomacromoléculas, Instituto de Química, Universidad Nacional Autónoma de México, Ciudad de México, Mexico;2. Departamento de Biología, División de Ciencias Naturales y Exactas, Campus Guanajuato, Universidad de Guanajuato, Guanajuato, Mexico;1. Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú;2. Hospital Cayetano Heredia, Lima, Perú;3. Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina Universidad de Chile, Santiago, Chile;4. Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas (CSIC)/Universidad de Sevilla y CIBER de Epidemiología y Salud Pública, Sevilla, España;1. Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain;2. Mycology Unit, Medical School and IISPV, Universitat Rovira i Virgili, Reus, Spain;3. Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, TN, USA |
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| Abstract: | BackgroundCryptococcosis is a generally systemic and potentially lethal fungal infection. Although HIV infection is a predisposing condition, especially if the CD4+ lymphocyte count is less than 100 cells/mm3, other forms of immunosuppression may be associated with this opportunistic fungal condition, such as prolonged steroid therapy or solid organ transplantation. Pulmonary presentation must be included in the differential diagnosis of pneumonia or pulmonary neoplasia in the immunosuppressed patient.Case reportWe report a case of pulmonary cryptococcosis in a non-diagnosed HIV patient. In a 44 year-old male suffering from dyspnea and chest pain the image of a pulmonary nodule was observed in a radiological finding. In the histopathological study, intracellular structures suggestive of fungal conidia, and morphologically compatible with Cryptococcus, were observed. HIV serology and cryptococcal antigen detection in serum were requested, given the possibility of cryptococcosis. Cryptococcus neoformans var. grubii was isolated from the culture of the pulmonary biopsy. The patient was finally diagnosed with pulmonary cryptococcosis and HIV-1 infection. With a proper antifungal treatment the patient evolved satisfactorily.ConclusionsThe best strategy to avoid opportunistic infections such as cryptococcosis in HIV-infected patients consists of an early diagnosis and a highly active antiretroviral treatment. In our case, the diagnosis of a pulmonary infection by C. neoformans var. grubii allowed a late diagnosis of HIV-1 infection. |
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| Keywords: | Pulmonary cryptococcosis HIV Histopathology Criptococosis pulmonar VIH Histopatología |
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