Acta bioquímica clínica latinoamericana
versión On-line ISSN 1851-6114
A case of pulmonary cryptococcosis in a 30-year-old woman, HIV positive since 1997, who was hospitalized with malaise, diarrhea, generalized myalgias and fever is communicated. As laboratory abnormal data, the patient showed 28% hematocrite, 1,900 leukocytes/mm3 and 100,000 platelets/mm3. She evolved into dry cough, dyspnea and abdominal pain without neurological symptoms, a positive parasitological study for Isospora belli and positive blood cultures for Cryptococcus neoformans. Chest radiology showed a bilateral interstitial infiltrate, similar to that produced by Pneumocystis jiroveci in AIDS patients. Capsulated yeasts, later identified as C. neoformans, were observed in a wet mount examination of respiratory secretions obtained by bronchoalveolar lavage, sent for analysis of P. jiroveci. Subsequently, India ink microscopy of a CSF sample showed capsulated yeasts and the patient was treated with amphotericin B in the usual dose; in spite of that, she died ten days after admission. Pulmonary cryptococcosis is a rarely diagnosed localization of this mycosis in AIDS patient, and its diagnosis requires the microscopic visualization and/or isolation of C. neoformans from respiratory secretions. The presence of C. neoformans in respiratory samples compels the search for the likely localization of this yeast in the CSF, in spite of the absence of symptoms of the neurological condition.
Palabras clave : Pulmonary cryptococcosis; AIDS associated cryptococcosis; Human immunodeficiency virus.