A Case of Mediastinal and Pulmonary Cryptococcosis in a 3-Year-Old Immunocompetent Girl
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Cryptococcosis is an infrequently recognized infection in children, particularly those who are immunocompetent. The disease is mainly caused by Cryptococcus neoformans, a fungal pathogen that primarily affects the central nervous system (CNS) and lungs. Most reports of children with cryptococcosis are of the CNS or disseminated infections among immunocompromised patients. This report is a case of a 3-year-old immunocompetent girl who presented with intermittent fever and cough; a large mass was found in the right infrahilar area on chest X-ray. Chest computed tomography revealed large conglomerated mediastinal lymph nodes caused by C. neoformans, which was confirmed by the polymerase chain reaction as well as a histological evaluation. The patient improved after a prolonged period of antifungal therapy. This is the only known report of mediastinal and pulmonary cryptococcosis in an immunocompetent child.
Abstract
Cryptococcosis is an infrequently recognized infection in children, particularly those who are immunocompetent. The disease is mainly caused by Cryptococcus neoformans, a fungal pathogen that primarily affects the central nervous system (CNS) and lungs. Most reports of children with cryptococcosis are of the CNS or disseminated infections among immunocompromised patients. This report is a case of a 3-year-old immunocompetent girl who presented with intermittent fever and cough; a large mass was found in the right infrahilar area on chest X-ray. Chest computed tomography revealed large conglomerated mediastinal lymph nodes caused by C. neoformans, which was confirmed by the polymerase chain reaction as well as a histological evaluation. The patient improved after a prolonged period of antifungal therapy. This is the only known report of mediastinal and pulmonary cryptococcosis in an immunocompetent child.
참고문헌 (20)
- Sweeney DA, "A ten-year-old boy with a pulmonary nodule secondary to Cryptococcus neoformans: case report and review of the literature", Pediatr Infect Dis J, 22, pp.1089~1093 (2003)
- Chang WC, "Pulmonary cryptococcosis: comparison of clinical and radiographic characteristics in immunocompetent and immunocompromised patients", Chest, 129, pp.333~340 (2006)
- Leggiadro RJ, "Extrapulmonary cryptococcosis in immunocompromised infants and children", Pediatr Infect Dis J, 11, pp.43~47 (1992)
- Severo CB, "Cryptococcosis in children", Paediatr Respir Rev, 10, pp.166~171 (2009)
- Jean SS, "Cryptococcaemia: clinical features and prognostic factors", QJM, 95, pp.511~518 (2002)
- Chaudhary MW, "Disseminated infection with Cryptococcus neoformans var neoformans in an 8 years immunocompetent girl", Indian J Pediatr, 72, pp.85~ (2005)
- Nadrous HF, "Pulmonary cryptococcosis in nonimmunocompromised patients", Chest, 124, pp.2143~2147 (2003)
- Himmel JE, "Cryptococcal pneumonia in an immunocompetent host: radiographic findings", Semin Respir Infect, 18, pp.129~131 (2003)
- Huang KY, "Cryptococcosis in nonhuman immunodeficiency virus- infected children", Pediatr Neurol, 42, pp.267~270 (2010)
- Yuanjie Z, "Cryptococcal meningitis in an immunocompetent 8- year-old girl", Mycoses, 52, pp.377~378 (2009)
- Vawda F, "Massive cryptococcal lymphadenopathy in an immunocompetent pregnant patient", Br J Radiol, 81, pp.e53~6 (2008)
- Sinha P, "Mediastinal cryptococcoma", Thorax, 33, pp.657~659 (1978)
- Zou CC, "Primary abdominal lymphonodular cryptococcosis in children: 2 case reports and a literature review", J Pediatr Surg, 41, pp.e11~e15 (2006)
- Rozenbaum R, "Clinical epidemiological study of 171 cases of cryptococcosis", Clin Infect Dis, 18, pp.369~380 (1994)
- Jarvis JN, "Pulmonary cryptococcosis", Semin Respir Crit Care Med, 29, pp.141~150 (2008)
- Lindell RM, "Pulmonary cryptococcosis: CT findings in immunocompetent patients", Radiology, 236, pp.326~331 (2005)
- Sun LM, "Cryptococcus infection in a patient with nasopharyngeal carcinoma: imaging findings mimicking pulmonary metastases", Br J Radiol, 75, pp.275~278 (2002)
- Núñez M, "Pulmonary cryptococcosis in the immunocompetent host. Therapy with oral fluconazole: a report of four cases and a review of the literature", Chest, 118, pp.527~534 (2000)
- Dromer F, "Comparison of the efficacy of amphotericin B and fluconazole in the treatment of cryptococcosis in human immunodeficiency virus-negative patients: retrospective analysis of 83 cases. French Cryptococcosis Study Group", Clin Infect Dis, 22(Suppl 2), pp.S154~60 (1996)
- Perfect JR, "Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America", Clin Infect Dis, 50, pp.291~322 (2010)