Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/70027
Title: Pulmonary nodules: An unusual onset of HIV infection belatedly diagnosed
Authors: Bastón Paz, Natalia
Hernández Betancor, Araceli
Esparza Morera, Rafael
Báez Acosta, Beatriz
Santana Rodríguez, Évora
Martín Sánchez, Antonio Manuel 
UNESCO Clasification: 320505 Enfermedades infecciosas
320508 Enfermedades pulmonares
Keywords: Cryptococcus Neoformans
Histopathology
Hiv
Pulmonary Cryptococcosis
Issue Date: 2019
Journal: Revista Iberoamericana de Micologia 
Abstract: Background: Cryptococcosis 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 report: We 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. Conclusions: The 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.
URI: http://hdl.handle.net/10553/70027
ISSN: 1130-1406
DOI: 10.1016/j.riam.2019.04.005
Source: Revista Iberoamericana de Micologia [ISSN 1130-1406], v. 36 (3), p. 151-154
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