Imaging of pulmonary cryptococcosis with consolidations or diffuse infiltrates suggests longer clinical treatment in non-HIV patients.

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  • Additional Information
    • Source:
      Publisher: International Research and Cooperation Association for Bio & Socio-Sciences Advancement Country of Publication: Japan NLM ID: 101502754 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1881-7823 (Electronic) Linking ISSN: 18817815 NLM ISO Abbreviation: Biosci Trends Subsets: MEDLINE
    • Publication Information:
      Original Publication: Tokyo : International Research and Cooperation Association for Bio & Socio-Sciences Advancement
    • Subject Terms:
      Cryptococcosis*/diagnostic imaging ; Cryptococcosis*/drug therapy ; Cryptococcosis*/diagnosis ; Lung Diseases, Fungal*/diagnostic imaging ; Lung Diseases, Fungal*/drug therapy ; Lung Diseases, Fungal*/diagnosis; Humans ; Male ; Female ; Middle Aged ; Aged ; Antifungal Agents/therapeutic use ; Adult ; Lung/diagnostic imaging ; Lung/pathology ; Lung/microbiology ; Tomography, X-Ray Computed
    • Abstract:
      This article was to summarize the clinical features and treatment course in patients with pulmonary cryptococcal infections with different imaging manifestations and to analyse the relevant factors. Categorical variables are described in this paper as percentages, and continuous variables are expressed as medians and quartiles or means and standard deviations. Factors associated with prolonged treatment of pulmonary cryptococcosis with different imaging manifestations were estimated via multivariable analyses with the Cox proportional hazards model. A total of 238 patients were analysed. A significant proportion of patients with diabetes mellitus constituted 18% to 25% of patients with multiple nodules and diffuse infiltrates (p = 0.026). The serum antigen level was markedly elevated in patients with diffuse infiltrates and consolidation (p < 0.001). A significant proportion of patients who presented with solitary nodules were initially diagnosed through thoracic surgery conducted to remove the lesion (p < 0.001). The treatment duration for patients with pulmonary cryptococcosis presenting as single or multiple nodules on imaging was shorter than the traditionally considered 6 months (p < 0.001). Imaging revealed that pulmonary cryptococcosis most commonly involved the right lower lung. Serum antigen assays, the number of infectious lobes, the presence of extrapulmonary lesions and the presence of lesions in the lower right lobe were suggested to be predictive indicators for a longer treatment duration. There was no significant difference in the percentage of patients who used amphotericin B or amphotericin B liposomes among patients with the four different types of imaging presentations.
    • Contributed Indexing:
      Keywords: imaging characteristics; prognosis; pulmonary cryptococcosis; treatment
    • Accession Number:
      0 (Antifungal Agents)
    • Publication Date:
      Date Created: 20241023 Date Completed: 20241117 Latest Revision: 20241117
    • Publication Date:
      20241118
    • Accession Number:
      10.5582/bst.2024.01288
    • Accession Number:
      39443117