Hypersensitivity pneumonitis complicated with cryptococcosis:a case report and literature review
ZENG Jian
LI Jingxiang
TIAN Rulan
CUI Jia
Abstract：A 63-year-old male patient admitted to Beijing Hospital presented with exertional dyspnea for 2 years and aggravated symptoms with cough and sputum production for 5 months.He had a long-term history of pigeon breeding.Di-agnostic findings include positive serum cryptococcal capsular antigen,chest CT revealing bilateral diffuse ground-glass o-pacities with three-density sign in mid-lower lung fields and elevated lymphocyte proportion in bronchoalveolar lavage fluid.According to HP-2020 guideline and cryptococcosis-2024 guideline,he was diagnosed as hypersensitivity pneumonitis com-plicated with cryptococcosis.Considering the risk of corticosteroid-induced fungal dissemination,sequential therapy was implemented.Initial fluconazole therapy showed limited clinical or radiographic improvement.Prednisone was initiated af-ter achieving cryptococcal antigen seroconversion,resulting in significant symptom resolution.Although the cooccurrence of hypersensitivity pneumonitis and pulmonary cryptococcosis is rare in clinical practice,their shared etiological factors.Pre-treatment screening for pulmonary cryptococcosis is imperative prior to corticosteroid therapy to reduce the risk of Cryptococcus dissemination.
Keywords：Cryptococcus neoformans infectionpulmonary cryptococcushypersensitivity pneumonitiscorticoste-roid therapy
Publication Date：2025-10-28
Online Publishing Date：2025-11-19(First online date of this platform, not the publication date of the document)
Pages：4( 534-537 )