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Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients
BACKGROUND: Current understanding of human immunodeficiency virus (HIV)-associated pulmonary cryptococcosis (PC) is largely based on studies performed about 2 decades ago which reported that the most common findings on chest radiograph were diffuse interstitial infiltrates. Few studies are available...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354418/ https://www.ncbi.nlm.nih.gov/pubmed/28301552 http://dx.doi.org/10.1371/journal.pone.0173858 |
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author | Hu, Zhiliang Chen, Jun Wang, Juan Xiong, Qingfang Zhong, Yandan Yang, Yongfeng Xu, Chuanjun Wei, Hongxia |
author_facet | Hu, Zhiliang Chen, Jun Wang, Juan Xiong, Qingfang Zhong, Yandan Yang, Yongfeng Xu, Chuanjun Wei, Hongxia |
author_sort | Hu, Zhiliang |
collection | PubMed |
description | BACKGROUND: Current understanding of human immunodeficiency virus (HIV)-associated pulmonary cryptococcosis (PC) is largely based on studies performed about 2 decades ago which reported that the most common findings on chest radiograph were diffuse interstitial infiltrates. Few studies are available regarding the computed tomography (CT) findings. The aim of this study was to characterize chest CT features of HIV-associated PC. METHODS: HIV patients with cryptococccal infection and pulmonary abnormalities on Chest CT between September 2010 and May 2016 in the Second Affiliated Hospital of the Southeast University were retrospectively analyzed. Confirmed cases of tumors, mycobacterial infections and other fungal infections were excluded from the analysis. RESULTS: 60 cases were identified. The median CD4 T-cell counts were 20 cells/μL (range, 0–205 cells/μL). Chest CT scans demonstrated nodular lesions in 93.3% of the studied patients. Those nodular lesions were usually cavitated and solitary nodule was the most common form. Pleural effusions and pneumonic infiltrates occurred in 11.6% and 31.7% of the cases respectively. Those lesions were usually had co-existing nodular lesions. Etiological analysis suggested that 76.8% of the nodular lesions could have a relationship with PC that 12.5% of the nodular lesions were “laboratory-confirmed” cases, 48.2% were “clinically confirmed” cases and 16.1% were “clinically probable” cases. 85.7% of the pleural effusions could be “clinically confirmed” cases of PC. At least, 38.5% of the diffuse pneumonic infiltrates may be clinically attributed to pneumocystis pneumonia. CONCLUSIONS: This study suggested that pulmonary nodules but not diffuse pneumonia are the most common radiological characteristics of HIV-associated PC. HIV-infected patients with pulmonary nodules on Chest CT should particularly be screened for cryptococcal infection. |
format | Online Article Text |
id | pubmed-5354418 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-53544182017-04-06 Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients Hu, Zhiliang Chen, Jun Wang, Juan Xiong, Qingfang Zhong, Yandan Yang, Yongfeng Xu, Chuanjun Wei, Hongxia PLoS One Research Article BACKGROUND: Current understanding of human immunodeficiency virus (HIV)-associated pulmonary cryptococcosis (PC) is largely based on studies performed about 2 decades ago which reported that the most common findings on chest radiograph were diffuse interstitial infiltrates. Few studies are available regarding the computed tomography (CT) findings. The aim of this study was to characterize chest CT features of HIV-associated PC. METHODS: HIV patients with cryptococccal infection and pulmonary abnormalities on Chest CT between September 2010 and May 2016 in the Second Affiliated Hospital of the Southeast University were retrospectively analyzed. Confirmed cases of tumors, mycobacterial infections and other fungal infections were excluded from the analysis. RESULTS: 60 cases were identified. The median CD4 T-cell counts were 20 cells/μL (range, 0–205 cells/μL). Chest CT scans demonstrated nodular lesions in 93.3% of the studied patients. Those nodular lesions were usually cavitated and solitary nodule was the most common form. Pleural effusions and pneumonic infiltrates occurred in 11.6% and 31.7% of the cases respectively. Those lesions were usually had co-existing nodular lesions. Etiological analysis suggested that 76.8% of the nodular lesions could have a relationship with PC that 12.5% of the nodular lesions were “laboratory-confirmed” cases, 48.2% were “clinically confirmed” cases and 16.1% were “clinically probable” cases. 85.7% of the pleural effusions could be “clinically confirmed” cases of PC. At least, 38.5% of the diffuse pneumonic infiltrates may be clinically attributed to pneumocystis pneumonia. CONCLUSIONS: This study suggested that pulmonary nodules but not diffuse pneumonia are the most common radiological characteristics of HIV-associated PC. HIV-infected patients with pulmonary nodules on Chest CT should particularly be screened for cryptococcal infection. Public Library of Science 2017-03-16 /pmc/articles/PMC5354418/ /pubmed/28301552 http://dx.doi.org/10.1371/journal.pone.0173858 Text en © 2017 Hu et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Hu, Zhiliang Chen, Jun Wang, Juan Xiong, Qingfang Zhong, Yandan Yang, Yongfeng Xu, Chuanjun Wei, Hongxia Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients |
title | Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients |
title_full | Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients |
title_fullStr | Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients |
title_full_unstemmed | Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients |
title_short | Radiological characteristics of pulmonary cryptococcosis in HIV-infected patients |
title_sort | radiological characteristics of pulmonary cryptococcosis in hiv-infected patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354418/ https://www.ncbi.nlm.nih.gov/pubmed/28301552 http://dx.doi.org/10.1371/journal.pone.0173858 |
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