Abstract

MAQUERA-AFARAY, Julio; OLAZABAL-CHAMBILLA, Derly Yerson; LARICO-CALLA, Gabriel  and  DIAZ-QUIQUIA, Vasti Evelyn. Pulmonary Cryptococcosis masked by miliary tuberculosis. Pulmonary coinfection and diagnostic & therapy implications in HIV-infected patients. Acta méd. Peru [online]. 2016, vol.33, n.4, pp.313-316. ISSN 1728-5917.

Cryptococcal disease is a mycosis frequently associated with HIV infection, which mainly affects the central nervous system, followed by lung involvement. We report a case of an HIVinfected 53-year-old female patient, who developed a pulmonary co-infection (cryptococcosis and tuberculosis). The thoracic CT scan revealed micronodular and nodular lesions, and AFB were found in the sputum. Antituberculous therapy was started, but there was only partial improvement. Since pulmonary cryptococcosis was suspected, a serum cryptococcal antigen test was requested, which turned out to be positive. The diagnosis of the fungal disease was confirmed with a CT-guided biopsy of a pulmonary nodule. The patient received antifungal therapy and she did well. It is important to consider cryptococcosis not only as a condition affecting the central nervous system, but also to recognize its different and most frequent clinical and image manifestations which may allow us to timely diagnose it and differentiate it from other pulmonary conditions.

Keywords : Cryptococcosis; Tuberculosis; HIV.