[Pulmonary Cryptococcosis Treated with Antifungal Drugs After Surgical Resection:Report of a Case]

Kyobu Geka. 2024 Dec;77(13):1135-1140.
[Article in Japanese]

Abstract

The patient is an 81-year-old man. He underwent surgery for pancreatic body cancer in 201X and was followed up every six months with computed tomography (CT) imaging. A CT scan in 201X+5 showed a new nodule in S6 of the right lung. The nodule grew in the latter half of the year and was diagnostically resected on suspicion of being a metastatic lung tumor. A histopathological examination of the resected lung revealed pulmonary cryptococcosis. The postoperative course was uneventful, and the patient was treated with fluconazole 200 mg/day for six months. The patient is currently alive and recurrence-free three years after surgery. Pulmonary cryptococcosis can recur and may be complicated by meningitis. Postoperative antifungal therapy should be considered because of the poor prognosis of meningitis. Postoperative treatment should be performed with caution, especially in patients who are susceptible to infection, have positive preoperative serum cryptococcal antigen levels or have a high standardized uptake value (SUV) max on positron emission tomography (PET)-CT scanning, and are considered to have high fungal loads or activity.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged, 80 and over
  • Antifungal Agents* / administration & dosage
  • Antifungal Agents* / therapeutic use
  • Cryptococcosis* / diagnostic imaging
  • Cryptococcosis* / drug therapy
  • Cryptococcosis* / surgery
  • Fluconazole / administration & dosage
  • Fluconazole / therapeutic use
  • Humans
  • Lung Diseases, Fungal* / diagnostic imaging
  • Lung Diseases, Fungal* / drug therapy
  • Lung Diseases, Fungal* / surgery
  • Male
  • Pancreatic Neoplasms / surgery
  • Tomography, X-Ray Computed

Substances

  • Antifungal Agents
  • Fluconazole