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Cryptococcus gattii Infection Presenting as an Aggressive Lung Mass

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Abstract

Cryptococcus gattii is an endemic fungus predominantly isolated in the tropical and subtropical regions, causing predominantly pulmonary disease with a predilection for the central nervous system. Herein, we report a case of rapidly progressing C. gattii pneumonia in an immune-deficient but virologically suppressed host with underlying human immunodeficiency viral (HIV) infection, exhibiting various fungal morphologies from bronchoalveolar lavage (BAL) cytological specimens. A 51-year-old Chinese male with known HIV disease was admitted to the Singapore General Hospital for evaluation of functional decline, febrile episodes, and a left hilar mass on chest radiograph. Computed tomography (CT) showed consolidation in the apical segment of the left lower lobe. He underwent bronchoscopy and BAL. Positron emission tomography-computed tomography done 10 days after the initial CT showed approximate doubling of the pulmonary lesion. Cytological examination of the fluid revealed yeasts of varying sizes. Subsequent fungal culture from BAL fluid grew C. gattii 10 days later.

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Acknowledgements

We would like to thank Dr. Ong Tan Ching from the Research Office of Nanyang Technological University for helping us with the identification of pollen grains and fungal spores. We would also like to thank Dr. Tan Ai Ling, Ms. Tan Mei Gie, and Ms. Delphine Cao from the Department of Microbiology, Singapore General Hospital, for assisting us in the MLST analysis of the C. gattii isolate. Last but not least, we are grateful to the Medical Publication Support Unit, National University Health System, for their publication support.

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  1. Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore

    Shuwei Zheng, Thuan Tong Tan & Jaime Mei Fong Chien

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  1. Shuwei Zheng
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  2. Thuan Tong Tan
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Correspondence to Shuwei Zheng.

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Zheng, S., Tan, T.T. & Chien, J.M.F. Cryptococcus gattii Infection Presenting as an Aggressive Lung Mass. Mycopathologia 183, 597–602 (2018). https://doi.org/10.1007/s11046-017-0233-6

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  • DOI: https://doi.org/10.1007/s11046-017-0233-6

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