Treatment of asymptomatic pulmonary cryptococcosis in immunocompetent hosts with oral fluconazole

Kyoung Hwa Choi, Seoung Ju Park, Kyung-Hoon Min, So Ri Kim, Min Hee Lee, Chi Ryang Chung, Hyo Jin Han, Yong Chul Lee

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Pulmonary cryptococcosis is occasionally detected on routine imaging studies in healthy hosts with no or mild symptoms. Isolated pulmonary cryptococcosis may be observed without specific therapy in asymptomatic immunocompetent hosts. However, considering that dissemination from a pulmonary infection can occur in patients with no immunologic defects, treatment of asymptomatic pulmonary cryptococcosis in immunocompetent hosts remains controversial. The aim of this study was to determine the role of fluconazole therapy in the management of isolated pulmonary cryptococcosis in asymptomatic healthy hosts. Methods: We retrospectively analyzed the medical records and radiographic findings of 10 healthy subjects with isolated pulmonary cryptococcosis diagnosed incidentally and treated with oral fluconazole. Results: All patients had no respiratory or constitutional symptoms. The most common radiological findings were pulmonary nodules, and the number of nodules in each patient was from 1 to 9. After histological confirmation, all patients were treated with oral fluconazole at a dosage of 400 mg per day for a median period of 6.4 months. No patient developed an adverse reaction to fluconazole. The mean interval between the initiation of antifungal therapy and final radiological response was 8.3 months. Seven of the 10 patients showed complete resolution, and the other 3 patients were assessed as having partial resolution. During the average follow-up period of 11.9 months, all patients showed a favourable outcome with no relapse. The overall cure rate was 70%. Conclusion: These results suggest that fluconazole may be an attractive therapeutic option for asymptomatic pulmonary cryptococcosis in immunocompetent hosts.

Original languageEnglish
Pages (from-to)380-385
Number of pages6
JournalScandinavian Journal of Infectious Diseases
Volume43
Issue number5
DOIs
Publication statusPublished - 2011 May 1
Externally publishedYes

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Cryptococcosis
Fluconazole
Lung
Therapeutics
Medical Records
Healthy Volunteers
Recurrence

Keywords

  • fl uconazole
  • immunocompetent host
  • Pulmonary cryptococcosis

ASJC Scopus subject areas

  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Treatment of asymptomatic pulmonary cryptococcosis in immunocompetent hosts with oral fluconazole. / Choi, Kyoung Hwa; Park, Seoung Ju; Min, Kyung-Hoon; Kim, So Ri; Lee, Min Hee; Chung, Chi Ryang; Han, Hyo Jin; Lee, Yong Chul.

In: Scandinavian Journal of Infectious Diseases, Vol. 43, No. 5, 01.05.2011, p. 380-385.

Research output: Contribution to journalArticle

Choi, Kyoung Hwa ; Park, Seoung Ju ; Min, Kyung-Hoon ; Kim, So Ri ; Lee, Min Hee ; Chung, Chi Ryang ; Han, Hyo Jin ; Lee, Yong Chul. / Treatment of asymptomatic pulmonary cryptococcosis in immunocompetent hosts with oral fluconazole. In: Scandinavian Journal of Infectious Diseases. 2011 ; Vol. 43, No. 5. pp. 380-385.
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