Respiratory research · 2025
A multicenter prospective clinical cohort study of pulmonary cryptococcosis in adult non-HIV-infected patients in a southeastern province of China.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Chen Meiyan, Chen Shuyang, Wang Meng, Wang Huijuan, Zeng Shengyuan, Zhuang Liying, Lai Guoxiang, Yu Zongyang, You Yanjing, Xie Baosong, Yao Xiujuan, Chen Xiangqi, Lin Lan, Lin Qunying, Hu Yuxiong, Xu Liyu, Li Xiaohua, Chen Xiaohong, Wu Danmei, Chen Gongping, Liu Kaixiong, She Hui, Lin Li, Yu Guoqing, Wen Wen
Аннотация
BACKGROUND: This study investigates the clinical presentations, diagnostic approaches, and treatment outcomes of pulmonary cryptococcosis (PC) in non-HIV patients in Fujian Province, and explores the correlation between immunological status and clinical features.
METHODS: A prospective, multicenter cohort study was conducted from April 2017 to March 2022, involving 234 PC patients from 47 hospitals in nine prefecture-level cities in southeastern China's Fujian Province.
RESULTS: The study included 145 male and 89 female PC patients, average age 50.66 ± 14.11 years. Immunological status varied: 115 immunocompetent, 17 with potential immunodeficiency due to certain comorbidities, 69 with mild-to-moderate immunodeficiency, and 33 with severe immunodeficiency. Diabetes mellitus was the most common comorbidity. The prevalence of PC is higher in Eastern Fujian (51.7%). 18.4% of patients were exposed to birds/pigeons droppings prior to admission. 37.6% of patients were asymptomatic. Cough and expectoration were common symptoms. Radiologically, multiple lesions with subpleural and lower lobe involvement were typical. The Cryptococcus capsular antigen (CrAg) test showed a sensitivity of 94.9%. Fluconazole was the primary treatment (87.0%), followed by voriconazole. At final follow-up, 85.4% of patients had recovered or improved.
CONCLUSIONS: PC incidence in non-HIV-infected adults in Fujian is higher in males. Most patients were immunocompetent and from eastern Fujian, with few significant environmental exposures. Clinical and radiological findings were non-specific, highlighting diagnostic challenges. The CrAg test is a valuable diagnostic tool. Treatment with fluconazole and voriconazole resulted in favorable outcomes.
METHODS: A prospective, multicenter cohort study was conducted from April 2017 to March 2022, involving 234 PC patients from 47 hospitals in nine prefecture-level cities in southeastern China's Fujian Province.
RESULTS: The study included 145 male and 89 female PC patients, average age 50.66 ± 14.11 years. Immunological status varied: 115 immunocompetent, 17 with potential immunodeficiency due to certain comorbidities, 69 with mild-to-moderate immunodeficiency, and 33 with severe immunodeficiency. Diabetes mellitus was the most common comorbidity. The prevalence of PC is higher in Eastern Fujian (51.7%). 18.4% of patients were exposed to birds/pigeons droppings prior to admission. 37.6% of patients were asymptomatic. Cough and expectoration were common symptoms. Radiologically, multiple lesions with subpleural and lower lobe involvement were typical. The Cryptococcus capsular antigen (CrAg) test showed a sensitivity of 94.9%. Fluconazole was the primary treatment (87.0%), followed by voriconazole. At final follow-up, 85.4% of patients had recovered or improved.
CONCLUSIONS: PC incidence in non-HIV-infected adults in Fujian is higher in males. Most patients were immunocompetent and from eastern Fujian, with few significant environmental exposures. Clinical and radiological findings were non-specific, highlighting diagnostic challenges. The CrAg test is a valuable diagnostic tool. Treatment with fluconazole and voriconazole resulted in favorable outcomes.