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With weakened immunity, beware of cryptococcal infection arriving at your doorstep

A 56-year-old man in Chiayi, Taiwan went to the Chiayi branch of Taichung Rongzhong Hospital for treatment due to pneumonia and pleural hydrops. After examination, it was found that there were nodular shadows in the lung lobes. However, improvement after antibiotic treatment was limited. Further biopsy by pathologist Dr. Xie Yaowen revealed that it was rare. “Cryptococcal pneumonia” infection recovered spontaneously after using antifungal drugs.Physician Xie Yaowen said that cryptococcal infection usuallyimmunity to diseaseFor patients with incomplete symptoms, cooperate with the physician to diagnose and identify the cause of the disease and treat it.

The Zhongrong Chiayi branch said the man had a history of hepatitis C and cirrhosis. She sought medical treatment for pneumonia and pleural hydrops. After chest X-ray and computer tomography examination, it was found that there were multiple nodules in the lung lobes. Follow-up arrangements were made to examine the shadow, blood and sputum of the patient. There was bacterial infection in the sputum and blood, but no tuberculosis infection. Treatment with antibiotics showed that improvement in the pneumonia was not ideal, and further biopsy examination of the lung lesions was arranged. Doctor Xie Yaowen diagnosed the relatively rare “cryptococcal pneumonia” infection through pathological microscopic examination. He has now made a healthy recovery after using the antifungal agent fluconazole.

Doctor Xie Yaowen said that Cryptococcus is not a type of bacteria, but a type of fungus. The severity of cryptococcosis depends on the immune status of the patient. It may be asymptomatic or present with pneumonia, pleural effusion and other severe manifestations. Pulmonary infection is a common disease, and the symptoms are not the same as common bacterial pneumonia. There may be no obvious symptoms, or there may be a more chronic cough, fever, pleuritic pain, or weight loss. Central nervous system infections usually have an acute or chronic course. Symptoms include fever, headache, nausea, vomiting etc. Vision loss may also occur. , Facial paralysis. Cryptococcal pneumonia often has characteristic computed tomography features, and can be diagnosed by bacteriology and pathological cytology based on clinical manifestations. Pathological examination should detect the presence of cryptococcal bacteria under the microscope via bronchoscopy or percutaneous transthoracic biopsy. Once cryptococcal pneumonia is diagnosed, especially if there is prolonged headache, fever, stiff neck, vomiting, or abnormal cranial nerve function. For patients, a lumbar puncture is recommended to rule out cryptococcal meningitis.

Doctor Xie Yaowen said that cryptococcal infection usually occurs in patients with weakened immunity, such as people suffering from AIDS lethal lymphoma.cancerPatients with low blood cells due to chemotherapy, erythrodermic lupus, sarcoidosis, diabetes, long-term steroid treatment or organ transplantation need to cooperate with doctors to treat antifungal drugs; He reminded that improving the above mentioned immune diseases can reduce the risk of infection. The only way to treat the symptoms is to treat the symptoms of Cryptococcus; In addition, although people with normal immunity can also be infected with Cryptococcus, the probability of occurrence is very low. If immunity is normal or it is a simple infection without obvious symptoms confirmed by a doctor, you can undergo continuous close observation for 2 to 3 months, this allows doctors to evaluate the lesions and provide different treatment strategies. Will get it. Most people can get a good prognosis. As long as the patient cooperates with the doctor in his treatment, there is no need to worry much.

Dr. Xie Yaowen, a physician at the Chiayi branch of Taichung Rong Zong Hospital, diagnosed the relatively rare “cryptococcal pneumonia” infection through pathological microscopic examination. (Provided by Taichung Wing Chiayi Branch)

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