Organizing pneumonia secondary to pulmonary cryptococcosis in immunocompromised patient

• Published in: Respiratory medicine case reports Vol. 47; p. 101975
• Main Authors: Saito, Zentaro, Ito, Takanori, Imakita, Takuma, Oi, Issei, Kanai, Osamu, Fujita, Kohei
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 2024; Elsevier
• Subjects: Cryptococcosis; Cryptococcus neoformans; Diabetes mellitus; Fungal disease; Immunocompromised host; Organizing pneumonia; Organizing pneumonia; Cryptococcus neoformans; Immunocompromised host; Diabetes mellitus; Cryptococcosis; Fungal disease
• ISSN: 2213-0071; 2213-0071
• DOI: 10.1016/j.rmcr.2023.101975

Pulmonary cryptococcal infections are fungal infections that often occur in immunocompromised patients and present with a variety of radiographic patterns ranging from nodular to infiltrative shadows. In the present case, we experienced a rare case of organizing pneumonia due to cryptococcal infection in a 71-year-old woman with rheumatoid arthritis. Transbronchial lung biopsy showing fibrotic changes in the alveolar walls, small granulation lesions and cryptococcal organisms with positive Grocott staining. Serum cryptococcal antigen was also found to be positive. Based on these findings, we confirmed the diagnosis of secondary organizing pneumonia due to cryptococcal infection. Treatment with corticosteroids and antifungal drugs led to improvement of the cough and reduction of organizing pneumonia. In immunocompetent patients with organizing pneumonia, it is essential to perform bronchoscopic lung biopsies and serum antigen tests to search for the cause, whenever possible, as it may be due to an infection caused by Cryptococcus, as in the present case.