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Intern Med ; 57(1): 115-120, 2018 Jan 01.
Article in English | MEDLINE | ID: mdl-29021481

ABSTRACT

Co-infection with cryptococcus and tuberculosis has rarely been reported. We herein report a case of an 80-year-old man with cryptococcal pleuritis concurrent with pulmonary tuberculosis. He was admitted for progression of left pleural effusion and consolidation in the left upper lobe. Culture for Mycobacterium tuberculosis was positive in sputum, and analyses of pleural effusion revealed lymphocyte-predominant high levels of adenosine deaminase (ADA). Medical thoracoscopy revealed massive infiltration of Cryptococcus neoformans in pleura without granuloma. This is the first case report of cryptococcal pleuritis coincident with pulmonary tuberculosis. Cryptococcal pleuritis should be ruled out when the adenosine deaminase levels are elevated in pleural effusion.


Subject(s)
Adenosine Deaminase/analysis , Coinfection/drug therapy , Coinfection/microbiology , Cryptococcosis/drug therapy , Prednisone/therapeutic use , Tuberculosis, Pleural/physiopathology , Tuberculosis, Pulmonary/physiopathology , Aged, 80 and over , Anti-Inflammatory Agents/therapeutic use , Coinfection/physiopathology , Cryptococcus neoformans/isolation & purification , Humans , Lymphocytes/chemistry , Male , Mycobacterium tuberculosis/isolation & purification , Pleura/microbiology , Pleura/physiopathology , Pleural Effusion/microbiology , Pleurisy/microbiology , Treatment Outcome , Tuberculosis, Pleural/drug therapy , Tuberculosis, Pleural/microbiology , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/microbiology
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