naika02@hospital-isahayasougou.jp Pulmonary cryptococcosis in the immunocompetent patient sometimes resolves spontaneously, without treatment 3. Cryptococcus neoformans infection localized to the lung and occurring in the absence of other pulmonary or systemic disease, is a distinct entity which presents specific problems of diagnosis and management. Pulmonary cryptococcosis presenting as endobronchial lesions in a patient under corticosteroid treatment. With treatment, the prognosis in pulmonary cryptococcosis is good. In case of dissemination to the CNS, itraconazole should not be used because it does not penetrate the CSF efficiently. Limper AH, Knox KS, Sarosi GA, et al; American Thoracic Society. People who have C. neoformans infection need to take prescription antifungal medication for at least 6 months, often longer.The type of treatment usually depends on the severity of the infection and the parts of the body that are affected. Diagnosis is clinical and microscopic, confirmed by culture or fixed-tissue staining. It is prudent to treat infected patients with fluconazole, and follow-up for 1 year is recommended because pulmonary cryptococcosis may disseminate. In cases of mild or moderate isolated pulmonary cryptococcosis, treatment with fluconazole or itraconazole (200-400 mg/day) can be administered for 6-12 months. In an attempt to answer this question of whether or not nonimmunocompromised patients with pulmonary cryptococcosis need antifungal therapy, we identified such patients who had been seen at our institution over a 26-year period from 1976 thru 2001, and examined their clinical presentation, diagnostic evaluation, treatment, clinical course, and outcome. Cryptococcus causes pulmonary cryptococcosis, and in some patients, the infection may remain latent or oligosymptomatic for a long period. The treatment of pulmonary cryptococcosis depends on the immune status of the patient. Most experts suggest that an infectious disease specialist should help guide the often long-term treatment with multiple antifungal medications. However, pulmonary cryptococcosis can spread to the central nervous system and cause life‐threatening meningitis 4. Cases of pulmonary cryptococcosis in patients with normal immune function are increasingly common in China. The treatment of pulmonary cryptococcosis with out central nervous system involvement is not defined. Pulmonary Cryptococcosis is a common fungal infection mainly caused by Cryptococcus neoformans/C.gattii species in immunocompromised patients. Cryptococcosis is a pulmonary or disseminated infection acquired by inhalation of soil contaminated with the encapsulated yeasts Cryptococcus neoformans or C. gattii. Study objectives: To determine the role of antifungal therapy in the management of isolated pulmonary cryptococcosis in nonimmunocompromised hosts. These treatment recommendations are well summarized elsewhere. Cryptococcosis (also known as torulosis and European blastomycosis) usually begins as a pulmonary infection that produces no signs or symptoms. Design: Retrospective study. Treatment of pulmonary cryptococcosis in non-HIV infected patients depends upon the patient’s immune status, presence of symptoms, and degree of extrapulmonary involvement. Symptoms are those of pneumonia, meningitis, or involvement of skin, bones, or viscera. Clinical and radiographic features of pulmonary cryptococcosis are various and without obvious characteristics, … The treatment and medications depend on the patient's overall condition (for example, HIV/AIDS, immunocompetent, having brain lesions or only pulmonary lesions) and the extent of the cryptococcal infection (single organ or multiple organ involvement). An official American Thoracic Society statement: Treatment of fungal infections in adult pulmonary and critical care patients. Inoue Y(1), Miyazaki Y, Izumikawa K, Yanagihara K, Kakeya H, Sawai T, Hirakata Y, Kohno S. Author information: (1)Department of Internal Medicine, Isahaya Insurance General Hospital, Nagasaki. Cryptococcus infection and development of cryptococcosis in humans generally occurs due to inhalation of yeasts or spores of Cryptococcus neoformans and Cryptococcus gattii present in the environment [1,2]. However, isolated pulmonary cryptococcosis in nonimmunocompromised hosts has been reported to resolve spontaneously without treatment. It then disseminates to extrapulmonary sites, including the central nervous system (CNS), skin, bones, prostate gland, liver, and kidneys.
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