Pulmonary Cryptococcosis That Mimicked Rheumatoid Nodule in Rheumatoid Arthritis Lesion.
10.4046/trd.2014.77.6.266
- Author:
Dong Won JANG
1
;
Ina JEONG
;
Seon Jae KIM
;
Seok Won KIM
;
Soo Yeon PARK
;
Yong Hwan KWON
;
Yeon Oh JEONG
;
Ji Yeon LEE
;
Bo Sung KIM
;
Woo Shik KIM
;
Joon Sung JOH
Author Information
1. Department of Internal Medicine, National Medical Center, Seoul, Korea. inajeong@gmail.com
- Publication Type:Case Report
- Keywords:
Cryptococcus;
Cryptococcosis;
Rheumatoid Nodule;
Arthritis, Rheumatoid
- MeSH:
Arthritis, Rheumatoid*;
Biopsy;
Biopsy, Needle;
Cerebrospinal Fluid;
Cryptococcosis*;
Cryptococcus;
Female;
Fluconazole;
Humans;
Incidence;
Methotrexate;
Radiography;
Rheumatoid Nodule*;
Thoracic Surgery, Video-Assisted;
Triamcinolone
- From:Tuberculosis and Respiratory Diseases
2014;77(6):266-270
- CountryRepublic of Korea
- Language:English
-
Abstract:
Recently, the incidence of pulmonary cryptococcosis is gradually increasing in rheumatoid arthritis (RA) patients. Pulmonary rheumatoid nodules (PRN) are rare manifestations of RA. Eighteen months ago, a 65-year old woman was admitted to hospital due to multiple nodules (2.5x2.1x2 cm) with cavitations in the right lower lobe. She was diagnosed with RA three year ago. She had been taking methotrexate, leflunomide, and triamcinolone. A video-assisted thoracoscopic surgery biopsy was performed and PRN was diagnosed. However, a newly growing huge opacity with cavitation was detected in the same site. Pulmonary cryptococcal infection was diagnosed through a transthoracic computed tomograpy guided needle biopsy. Cryptococcus antigen was detected in serum but not in cerebrospinal fluid. The patient was treated with oral fluconazole which resulted clinical improvement and regression of the nodule on a series of radiography. Herein, we report the case of pulmonary cryptococcosis occurring in the same location as that of the PRN.
