Resumen de Problemas clínicos en micología médica: problema número 46
Ricardo Negroni, Alicia Arechavala, Gabriela Santiso, Pablo Bonvehí
A 49 year old-man, without known previous diseases, who suffered an acute lung infection, is presented. He was a smoker and belonged to a high socioeconomic class. He suddenly presented high fever, dry cough and legs� pain. Thorax X-ray and CT scan showed two excavated pneumonic in?ltrates in the lower part of the right lung. He was treated with antibacterial antibiotics without clinical response. A transparietal ?ne needle lung biopsy was performedandthehistopathologyandcytological studies revealedanepithelioidgranulomawithcapsulatedyeasts.Cryptococcusneoformansantigenemia was positive 1/128, and brain MR, as well as CSF studies, allowed to rule out a central nervous system compromise. The patient was successfully treated with itraconazole by oral route at a daily dose of 400mg during 6 months. Post-treatmentthorax CT scan showed a thin walled lung cavity as a sequela
