摘要
Abstract
Objective To investigate the clinical features of pulmonary cryptococcosis(PC) in immunocompromised and immunocompetent patients with a view to helping clinicians to improve the level of diagnosis and treatment of the disease.Methods A retrospective study was conducted on 84 selected inpatients with PC treated in Jinhua People′s Hospital from January 2008 to December 2015.Of them,those with AIDS,or organ transplant,or long-term treatment with corticoid and immunosuppressive drugs were assigned to the immunocompromised group(43 cases),and the other who had not the above mentioned diseases or treatment were assigned to the immunocompetent group(41 cases).The baseline characteristics,clinical manifestations and auxiliary examination results were collected and compared between the two groups.Results Compared with the immunocompetent group,the immunocompromised group had shorter time needed to make the diagnosis(time was calculated from the admission),longer length of stay and higher mortality rate(P<0.05).The incidences of headache,nausea and vomiting,and cryptococcal meningitis in the immunocompromised group were higher than those in the immunocompetent group(P<0.05).The white blood cell count,serum albumin level,the positive rate of cryptococcal capsular polysaccharide antigen,CD3+T lymphocytes and CD4+T lymphocytes levels in the immunocompromised group were lower than those in the immunocompetent group(P<0.05).The immunocompromised group had lower incidences of solitary nodule/mass lesion but higher incidences of multiple nodules/mass lesions than the immunocompetent group(P<0.05).The immunocompromised group had higher incidence of cavity and lower incidence of unilateral lung involvement compared with the immunocompetent group(P<0.05).Conclusion Immunocompromised patients with PC are prone to central nervous system involvement with headache,nausea and vomiting as the main reasons for most initial visits.Moreover,they are characterized by increased mortality rate,decreased positive rate of cryptococcal capsular polysaccharide antigen,and multiple nodules/mass lesions and increased probability of cavities and bilateral lung involvement as the main imaging performance.The immunocompetent patients with PC are often found to have a solitary nodule/mass lesion and unilateral lung involvement as the imaging performance.关键词
隐球菌病/肺/免疫减弱宿主/临床特征Key words
Cryptococcosis/Lung/Immunocompromised host/Clinical features分类
医药卫生
