Imaging features of pulmonary cryptococcal infection associated with acquired immun deficiency syndrome
ZHAO Yuejuan
ZHAO Sihua
ZHOU Shulin
XU Honglan
ZHAO Jing
YANG Dandan
ZHANG Enjun
Abstract：Objective To analyze the clinical and imaging features of pulmonary cryptococcal infection complicated with AIDS,so as to improve the cognition of the disease.Methods The clinical and imaging features of 54 patients with AIDS complicated with cryptococcal pneumonia were analyzed retrospectively from May 2019 to December 2020,including 38 males and 16 females,with an average age of 19-73(38.2±19.98)years old.Results Among the 54 patients,CD4 count ranged from 13 to 198 cells/μL,with a median of 42 cells/μL.Clinical features:8 cases(14.3%)were asymptomatic,37 cases(68.5%)had fever,38 cases(70.4%)had cough,37 cases(68.5%)had expectoration,28 cases(51.9%)had chest pain,40 cases(74.1%)had headache,6 cases(11.1%)had nausea and vomiting,5 cases(9.3%)had disturbance of consciousness,and 40 cases(74.1%)had cryptococcal meningitis.Lesion distribution:6 cases had single lesions(11.1%),48 cases had multiple lesions(88.9%),involving the upper lobe in 33 cases(61.1%),the middle lobe in 18 cases(33.3%),and the lower lobe in 36 cases(66.7%).Imaging features:nodules or masses were present in 39 cases(72.2%),with single nodules in 6 cases(11.1%),multiple nodules in 33 cases(61.1%),masses in 3 cases(5.6%),intranodular cavitation in 6 cases(11.1%),halo sign around nodules in 3 cases(5.6%),spiculation in 12 cases(22.2%),ground-glass opacity in 6 cases(11.1%);consolidation in 21 cases(37.5%);effusion in 20 cases(35.7%);cavitation in 36 cases(66.7%),with thick-walled cavities in 6 cases(11.1%)and thin-walled cavities in 30 cases(55.6%);interstitial reticular opacity in 15 cases(27.8%);mediastinal lymphadenopathy in 15 cases(27.8%);hilar lymphadenopathy in 13 cases(24.1%);pleural effusion in 0 cases(0%);mixed lesions in 45 cases(83.3%).Conclusion Clinical symptoms of AIDS-related pulmonary cryptococcosis are mainly fever,cough,and sputum production,with most patients having CD4 counts below 200 cells/μL;imaging findings exhibit certain characteristics,with multi-lobed and multifocal lesions being common,along with nodules,thin-walled cavities,consolidation,and ground-glass opacity;pleural effusion is extremely rare.
Keywords：AIDScryptococcal pneumoniaimage features
Publication Date：2024-05-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 518-522 )