Rapidly progressive pneumonia caused by Cryptococcus neoformans in the patient of granulomatosis with polyangiitis

A 57-year-old male who had been treated for granulomatosis with polyangiitis (GPA) presented with cough and back pain that had persisted for three days. Mild infiltration shadows and nodules were found on computed tomography images at that time. Increase of GPA lesions and/or bacterial pneumonia was initially suspected. However, serum Cryptococcus neoformans antigen was positive and the chest X-ray findings had worsened by the following day despite of appropriate antibiotic treatment. Thus, pneumonia due to C. neoformans was diagnosed because C. neoformans was also isolated blood and lung tissues, and he was treated with antifungal agents: L-AMB and 5-FC, and followed up by chest radiography on a daily basis.