1. Cryptococcal Pleuritis Presenting with Lymphocyte-predominant and High Levels of Adenosine Deaminase in Pleural Effusions Coincident with Pulmonary Tuberculosis
- Author
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Akihiro Takemasa, Yasuo Shimizu, Yoshiki Ishii, Naoya Ikeda, Yasutaka Machida, Hidenori Takizawa, Takafumi Umetsu, Yoshitomo Kushima, Kazuyuki Chibana, and Masaaki Miyoshi
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Tuberculosis ,Pleural effusion ,Adenosine Deaminase ,Cryptococcus ,Anti-Inflammatory Agents ,Case Report ,Mycobacterium tuberculosis ,03 medical and health sciences ,0302 clinical medicine ,Adenosine deaminase ,co-infection ,Internal Medicine ,medicine ,Thoracoscopy ,Humans ,030212 general & internal medicine ,Lymphocytes ,Pleurisy ,Tuberculosis, Pulmonary ,Aged, 80 and over ,biology ,medicine.diagnostic_test ,business.industry ,Coinfection ,General Medicine ,Cryptococcosis ,Tuberculosis, Pleural ,medicine.disease ,biology.organism_classification ,cryptococcal antigen test ,respiratory tract diseases ,Pleural Effusion ,Treatment Outcome ,cryptococcal pleuritis ,030228 respiratory system ,Granuloma ,biology.protein ,Cryptococcus neoformans ,Sputum ,Pleura ,Prednisone ,medicine.symptom ,business ,pulmonary tuberculosis - 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.
- Published
- 2017