A Study of Clinical Misdiagnosis of Pulmonary Torulosis
ZHU Min
BI Yi-hui
WU Jing-bo
Qian Ling
Du Yong
He Wei
MEI Zhou-fang
Abstract：Objective To analyze the clinical characteristics of pulmonary torulosis and its diagnostic methods, so as to reduce misdiagnosis rate. Methods One misdiagnosed case of pulmonary torulosis was retrospectively analyzed, and relevant literatures were reviewed. Results The female patient had been diagnosed as having pneumonia ( with/without TB) with pulmo-nary CT in another hospital. Her condition deteriorated after corresponding treatment, and then she was admitted to our hospital for cough, sputum with fever for one month, and lung CT examination showed multiple exudation with consolidations in left lung, especially in lower lobe. Cryptococcal latex agglutination test(+) , titers of 1∶ 480 parallel;bronchoscopy transbronchial lung biopsy ( TBLB) had a tendency of cryptococcal infection. Immunohistochemistry showed CD68 ( epithelial cells +) , PAS (+) , six methenamine silver (+) , tuberculosis (-) . Bronchoalveolar lavage fluid inspection reported:Cryptococcus neofor-mans(+) . The patient was diagnosed as having pulmonary cryptococcosis, and underwent Levofloxacin and Fluconazole treat-ment. After 3 weeks of treatment, the second lung CT showed that lung lesions were significantly absorpted, and then the patient was discharged from the hospital. Conclusion Patients with multiple pulmonary exudative lesions, sustained low fever refracto-ry to treatment should be highly suspected as having pulmonary cryptococcosis. Pathology, cryptococcal latex agglutination test, and bronchoalveolar lavage fluid cryptococcal examination are of important significance in the process of diagnosis.
Keywords：TorulosisLungMisdiagnosisPneumoniaTuberculosispulmonary
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 43-46 )