[Dynamic research of serum cryptococcal capsular polysaccharide antigen titer and chest CT of pulmonary cryptococcosis after antifungal therapy].
Zhonghua Yi Xue Za Zhi
; 99(26): 2036-2041, 2019 Jul 09.
Article
in Zh
| MEDLINE
| ID: mdl-31315373
ABSTRACT
Objective:
To observe the dynamic changes of serum cryptococcal capsular polysaccharide antigen (CrAg) titer and chest CT of pulmonary cryptococcosis (PC) after antifungal therapy.Methods:
A retrospective study was performed for patients with PC admitted to the Department of Pulmonary and Critical Care Medicine of the First Affiliated Hospital of Wenzhou Medical University from January 2015 to April 2018. Serum CrAg titers and Chest CT examination were performed for all the cases before and after treatment. The difference between immunocompetent hosts group and immunocompromised hosts group were compared and analyzed.Results:
Eighty-two patients with PC including 46 male (56.1%) and 36 (43.9%) female were enrolled. Fifty-two (63.4%) patients were proven PC and thirty (36.6%) patients were probable PC. Forty-five (54.9%) patients had underlying diseases. Fifty-four (65.9%) patients were immunocompetent hosts and twenty-eight (34.1%) patients were immunocompromised hosts. The mean duration of treatment was (7.9±2.4) months and the mean follow-up was (24.0±10.0) months. Improvement (≥75%) in chest CT were found in 64.8% of the cases in immunocompetent group and 67.9% in immunocompromised group after 6 months' treatment. Improvement (≥75%) was found in 88.9% of the cases with patchy infiltrates or consolidation and only 63.0% in nodular or mass-like type and mixed patterns of PC. The serum CrAg titer of 55 cases ranged from 1â¶4 to 1â¶160 before treatment (median 1â¶40) and decreased for all cases after treatment. The serum CrAg titer became negative in 20 cases at last. Mean time of serum CrAg titer turning negative was (11.8±8.1) months. The serum CrAg titer became negative or decreased to 1â¶1 in 24 cases after treatment cessation, of whom the serum CrAg titer ranged from 1â¶5 to 1â¶160 before treatment (median 1â¶20). The serum CrAg titer of 31 cases ranged from 1â¶4 to 1â¶640 before treatment (median 1â¶64), of whom the serum CrAg detections were still positive after treatment cessation, and CrAg titer was 1â¶10 (ranged from 1â¶2 to 1â¶160).Conclusions:
In PC, chest CT improves after antifungal treatment, and the infiltrates or consolidation type of PC resolves faster than nodular or mass-like shadows and mixed patterns in CT. The serum CrAg titer decreases after antifungal treatment.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cryptococcosis
Type of study:
Observational_studies
Limits:
Female
/
Humans
/
Male
Language:
Zh
Journal:
Zhonghua Yi Xue Za Zhi
Year:
2019
Document type:
Article
Affiliation country: