To analyze the clinical features and efficacy of pulmonary cryptococcosis in patients with non-immune deficiency.

To retrospectively analyze the medical records of 39 patients with pulmonary cryptococcosis diagnosed from January 2017 to June 2020 at the Army Special Medical Center, and analyze the following data: demographic data, underlying diseases, clinical manifestations, imaging features, and pathological examination results, Treatment plan and clinical outcome. The lung histopathological test results and sputum samples of all patients were collected to analyze whether there was cryptococcal infection. Some patients were tested for cryptococcal antigen, and the above results were analyzed and summarized.

The study analyzed 39 patients, 21 males and 18 females. Physical examination of 20 cases (51.28%) found pulmonary nodules, 19 cases (48.72%) had clinical symptoms of cough, sputum and fever, and 39 cases were diagnosed with pulmonary cryptococcosis. Among all patients, 32 cases (82.05%) underwent surgical removal of the diseased lung tissue followed by antifungal therapy, and pathological examination of the surgically removed lung tissue was performed to confirm cryptococcal infection; 7 cases (17.95%) were treated with antifungal drugs alone, 3 cases of lung biopsy confirmed pulmonary Cryptococcus, 1 case of serum Cryptococcus capsular polysaccharide antigen test was positive, 1 case of sputum culture showed Cryptococcus pneumoniae, 2 cases of alveolar lavage fluid detected Cryptococcus. During the follow-up, it was found that surgical resection combined with antifungal therapy had a lower risk of recurrence and a shorter course of treatment than those who were treated with drug antifungal therapy alone.

The clinical manifestations of patients with non-immune deficiency pulmonary cryptococcosis are not specific. Detection of cryptococcal antigens in serum or respiratory tract specimens or lung tissue biopsy is a diagnostic method to confirm cryptococcal infection. Surgery combined with antifungal drugs is an effective method for the treatment of cryptococcal pulmonary disease.