Open AccessEndogenous excess cortisol production and diabetes mellitus as predisposing factors for pulmonary cryptococcosis: A case report and literature review
Author(s) -
Balamugesh Thangakunam,
DJ Christopher,
Susy Kurian,
Raji Thomas,
Prince James
Publication year - 2008
Publication title -
lung india
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 25
eISSN - 0974-598X
pISSN - 0970-2113
DOI - 10.4103/0970-2113.45281
Subject(s) - cryptococcosis , medicine , cryptococcus neoformans , flucytosine , cryptococcus , amphotericin b , diabetes mellitus , lesion , pathology , immunology , gastroenterology , antifungal , dermatology , endocrinology , microbiology and biotechnology , biology
Pulmonary cryptococcosis usually occurs as an opportunistic infection in immunocompromised patients. Endogenous Cushing's syndrome is associated with cortisol excess and can predispose to development of cryptococcal infections. We report a case of diabetic patient with ACTH secreting pituitary tumour who developed a cavitating lung mass. Computed tomography-guided biopsy of the lesion revealed mucicarminophilic budding forms of cryptococcus. Broncheoalveolar lavage culture grew Cryptococcus neoformans. There was radiological response to treatment with liposomal Amphotericin, but patient ultimately succumbed to septicemia and multiorgan failure. Opportunistic infections with organisms like Cryptococcus neoformans, should be considered in patients with endogenous Cushing's syndrome and a pulmonary infiltrate.