Cryptococcal antigen testing of lung tissue homogenate improves pulmonary cryptococcosis diagnosis: Two case reports.

BACKGROUND: Pulmonary cryptococcosis (PC) is an opportunistic infectious disease of the respiratory system. Lung tissue biopsies, culture of respiratory samples (e.g., sputum, lung tissue, pleural fluid, and bronchoalveolar lavage fluid), and cryptococcal antigen (CrAg) testing are helpful for a definitive diagnosis. However, these tests are sometimes falsely negative. PC is often misdiagnosed or underdiagnosed owing to the absence of obvert symptoms, poor imaging specificity, and false-negative laboratory tests. CASE SUMMARY: We report two female patients who underwent computed tomography-guided percutaneous needle pulmonary biopsy of a lung nodule for a confirmed diagnosis. In both patients, the CrAg test on the lung biopsy tissue homogenate was positive, while the serum CrAg test was negative. Combined with the lung tissue pathology, we made the diagnosis of PC. Antifungal therapy was effective in both patients. CONCLUSION: Given the findings of our cases and the literature review, lung tissue homogenate CrAg testing can be helpful in improving the diagnosis of PC.

Value of eosinophil count in bronchoalveolar lavage fluid for diagnosis of allergic bronchopulmonary aspergillosis: A case report.

BACKGROUND: An immediate hypersensitive immune response to Aspergillus fumigatus antigens is one of the main characteristic features of allergic bronchopulmonary aspergillosis (ABPA). As ABPA is an allergic respiratory disease, immunoglobulin E and peripheral-blood eosinophilia have been used as diagnostic indicators. However, eosinophilia in bronchoalveolar lavage fluid (BALF) has not been considered in the diagnostic criteria for ABPA. CASE SUMMARY: We present a case of ABPA in which the eosinophil count in peripheral blood was not increased, whereas the eosinophil percentage in BALF reached 60%. After antifungal and hormone therapy, imaging revealed very good resolution of lung infiltration. CONCLUSION: The value of the eosinophil count in BALF for the diagnosis of ABPA is worthy of the clinician's attention, especially when the patient's clinical features lack specificity and the diagnostic parameters are negative.

[Comparative study of shaping ability between rotary ProTaper and Flexofile].

OBJECTIVE: To compare the shaping ability of rotary ProTaper and Flexofile in simulated resin root canals. METHODS: Forty simulated resin root canals were randomly assigned to two groups, one group for rotary ProTaper with crown-down technique and the other for Flexofile with balanced force technique. Change of working length and incidence of canal aberration and instruments failure were recorded. After preparation, the change of root canal curvature and the amount of resin removed at the inner and outer canal walls were measured with Image Pro Plus 5.0. The centring ability and total amount of resin removed were also assessed. RESULTS: In the model of simulated resin canals, ProTaper instruments maintained working length better. Canals prepared with ProTaper instruments remained better curvature and showed fewer aberration compared with those prepared with Flexofile (P < 0.01). ProTaper instruments performed a better centring ability. CONCLUSION: ProTaper instruments have a better shaping ability in simulated resin root canals.