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Bai X, Wang H, Tang Y, Xiao C, Gao Y, Tong H, Chen P, Wang M, Ren T. Lung adenocarcinoma concurrent with pulmonary cryptococcosis: a case report and literature review. BMC Pulm Med 2024; 24:416. [PMID: 39198795 PMCID: PMC11351499 DOI: 10.1186/s12890-024-03242-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 08/22/2024] [Indexed: 09/01/2024] Open
Abstract
Pulmonary cryptococcosis (PC) is a common opportunistic fungal infection caused by Cryptococcus neoformans or Cryptococcus gattii. PC primarily invades the respiratory system, followed by the central nervous system. Few clinical reports have examined the coexistence of PC and lung cancer. This study reports the case of a 54-year-old immunocompetent PC patient with lung adenocarcinoma. Chest CT revealed multiple nodules in the right lung, with the largest nodule located in the dorsal segment of the right lower lobe. 18 F‑FDG positron emission tomography-computed tomography (PET-CT) revealed elevated glucose metabolism in the dorsal segment of the right lower lobe, which suggested lung cancer. The metabolism level of the nodule in the basal segment of the right lower lobe and the anterior segment of the right upper lobe was not abnormally increased, but the possibility of a malignant tumour could not be excluded. The pulmonary nodules in the dorsal segment and the basal segment of the right lower lobe were simultaneously resected via video-assisted thoracic surgery (VATS), and the final histopathology revealed primary lung adenocarcinoma and pulmonary cryptococcal infection, respectively. After surgery, antifungal treatment was administered for 3 months. Over the 3-year follow-up, contrast-enhanced computed tomography (CT) revealed no recurrence of either disease. This case study highlights the possibility of dualism in the diagnosis of multiple pulmonary nodules on chest CT, such as the coexistence of lung cancer and PC. Surgical resection is recommended for micronodules that are not easy to diagnose via needle biopsy; in addition, early diagnosis and treatment are helpful for ensuring a good prognosis. This paper reports the clinical diagnosis and treatment of one patient with pulmonary cryptococcal infection of the right lung complicated with lung adenocarcinoma, including 3 years of follow-up, providing a reference for clinical practice.
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Affiliation(s)
- Xiaofeng Bai
- Department of the First Clinical College, Hubei University of Medicine, Renmin Road No. 30, Shiyan, 442000, Hubei, China
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, 32 Renmin South Road, Maojian District, Shiyan, 442000, Hubei, P.R. China
| | - Hansheng Wang
- Department of the First Clinical College, Hubei University of Medicine, Renmin Road No. 30, Shiyan, 442000, Hubei, China
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, 32 Renmin South Road, Maojian District, Shiyan, 442000, Hubei, P.R. China
| | - Yijun Tang
- Department of the First Clinical College, Hubei University of Medicine, Renmin Road No. 30, Shiyan, 442000, Hubei, China
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, 32 Renmin South Road, Maojian District, Shiyan, 442000, Hubei, P.R. China
| | - Chuanyong Xiao
- Department of the First Clinical College, Hubei University of Medicine, Renmin Road No. 30, Shiyan, 442000, Hubei, China
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, 32 Renmin South Road, Maojian District, Shiyan, 442000, Hubei, P.R. China
| | - Yujie Gao
- Department of the First Clinical College, Hubei University of Medicine, Renmin Road No. 30, Shiyan, 442000, Hubei, China
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, 32 Renmin South Road, Maojian District, Shiyan, 442000, Hubei, P.R. China
| | - Hanmao Tong
- Department of the First Clinical College, Hubei University of Medicine, Renmin Road No. 30, Shiyan, 442000, Hubei, China
- Department of Pathology, Taihe Hospital, Hubei University of Medicine, 32 Renmin South Road, Maojian District, Shiyan, 442000, Hubei, P.R. China
| | - Peipei Chen
- Department of the First Clinical College, Hubei University of Medicine, Renmin Road No. 30, Shiyan, 442000, Hubei, China
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, 32 Renmin South Road, Maojian District, Shiyan, 442000, Hubei, P.R. China
| | - Meifang Wang
- Department of the First Clinical College, Hubei University of Medicine, Renmin Road No. 30, Shiyan, 442000, Hubei, China.
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, 32 Renmin South Road, Maojian District, Shiyan, 442000, Hubei, P.R. China.
| | - Tao Ren
- Department of the First Clinical College, Hubei University of Medicine, Renmin Road No. 30, Shiyan, 442000, Hubei, China.
- Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, 32 Renmin South Road, Maojian District, Shiyan, 442000, Hubei, P.R. China.
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Ye X, Zhang L, Yang Q, Pan W, Zeng X. Rapid duplex flap probe-based isothermal assay to identify the Cryptococcus neoformans and Cryptococcus gattii. Front Cell Infect Microbiol 2024; 14:1321886. [PMID: 38558853 PMCID: PMC10981274 DOI: 10.3389/fcimb.2024.1321886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 02/19/2024] [Indexed: 04/04/2024] Open
Abstract
Cryptococcosis is a life-threatening invasive fungal infection with significantly increasing mortality worldwide, which is mainly caused by Cryptococcus neoformans and Cryptococcus gattii. These two species complexes have different epidemiological and clinical characteristics, indicating the importance of accurate differential diagnosis. However, the clinically used culture method and cryptococcal capsular antigen detection couldn't achieve the above goals. Herein, we established a novel duplex flap probe-based isothermal assay to identify the Cryptococcus neoformans and Cryptococcus gattii within 1 hour. This assay combined the highly sensitive nucleic acid isothermal amplification and highly specific fluorescence probe method, which could effectively distinguish the sequence differences of the two species complexes using two different fluorescence flap probes in a single reaction system. This novel method showed excellent detection performance with sensitivity (10 copies/μL each) and specificity (100%) compared to traditional culture and sequencing methods. Furthermore, we applied this method to spiked clinical samples, 30 cerebrospinal fluids and 30 bronchoalveolar lavage fluids, which kept good detection performance. This novel rapid duplex flap probe-based isothermal assay is a promising and robust tool for applications in differential diagnosis of the Cryptococcus neoformans and Cryptococcus gattii in clinical settings, especially when clinical suspicion for cryptococcal disease is high and epidemiological studies.
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Affiliation(s)
- Xin Ye
- Department of Laboratory Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Lei Zhang
- Department of Dermatology, The third affiliated hospital of Xi’an Jiaotong University, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China
| | - Qingqing Yang
- Department of Laboratory Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Weihua Pan
- Department of Dermatology, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Xiaoyan Zeng
- Department of Laboratory Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Baomo L, Guofen Z, Jie D, Liu X, Shuru C, Jing L. Disseminated cryptococcosis in a patient with idiopathic CD4 + T lymphocytopenia presenting as prostate and adrenal nodules: diagnosis from pathology and mNGS, a case report. BMC Infect Dis 2024; 24:26. [PMID: 38166809 PMCID: PMC10763445 DOI: 10.1186/s12879-023-08926-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
Disseminated Cryptococcosis infection typically occurs in immunocompromised patients, often manifested as pneumonia or meningoencephalitis. Cases with involvement of either prostate or adrenal glands are less frequent. We describe a case of an immunocompromised 62-year-old man with new-found Idiopathic CD4 + T lymphocytopenia who presented with urinary irritation symptoms followed by headache. The patient was finally diagnosed as disseminated cryptococcosis of prostate, adrenal gland involvement with the help of combining histopathology of formalin-fixed, paraffin-embedded tissue with metagenomic next-generation sequencing technique to identify C neoformans sensu stricto in prostate, adrenal gland tissues. Clinicians should be aware of atypical presentations of cryptococcal disease. In this case of cryptococcosis in immunocompromised patients, we find that cryptococcosis can affect varied organs simultaneously and should be considered in the differential of infectious diseases. And mNGS technology helps to confirm the diagnosis.
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Affiliation(s)
- Liu Baomo
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zeng Guofen
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, 510630, Guangzhou, China
| | - Dong Jie
- Department of Infectious Diseases, Zhuhai People's Hospital(Zhuhai Hospital affiliated with Jinan University), 519000, Zhuhai, China
| | - Xie Liu
- Department of Infectious Diseases, Shenzhen Longhua District People's Hospital, 518110, Shenzhen, China
| | - Chen Shuru
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, 510630, Guangzhou, China.
| | - Liu Jing
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, 510630, Guangzhou, China.
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A 52-Year-Old Obese Man With Persistent Cough. Chest 2022; 162:e291-e294. [PMID: 36494127 DOI: 10.1016/j.chest.2022.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/24/2022] [Accepted: 06/20/2022] [Indexed: 12/12/2022] Open
Abstract
CASE PRESENTATION A 52-year-old man was referred to our hospital with an abnormal chest radiography infiltrate. He presented with cough that persisted for 1 month without fever, chills, dyspnea, or sputum. He has been treated with clarithromycin 400 mg/d for 1 week with no improvement. He had a history of hypertension, hyperuricemia, and gastroesophageal reflux disease. He had no family history of respiratory disease. He smoked 10 cigarettes daily for 10 years, which he had quit 15 years ago. He denied a history of alcohol or illicit drug use, occupational exposure, recent travel, and exposure to TB. He reported being sexually active with one current partner.
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Qin Z, Zou Y, Huang Z, Yu N, Deng Z, Chen Z, Wang Y. Metagenomic next-generation sequencing contributes to the diagnosis of mixed pulmonary infection: a case report. Ann Clin Microbiol Antimicrob 2022; 21:52. [PMID: 36434704 PMCID: PMC9701064 DOI: 10.1186/s12941-022-00545-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Pulmonary cryptococcosis (PC) and mixed pulmonary infection are difficult to be diagnosed due to the non-specificity and their overlapping clinical manifestations. In terms of the clinical diagnosis of PC and mixed pulmonary infection, conventional tests have limitations such as a long detection period, a limited range of pathogens, and low sensitivity. Metagenomics next-generation sequencing (mNGS) is a nascent and powerful method that can detect pathogens without culture, to diagnose known and unexplained infections in reduced time. CASE PRESENTATION A 43-year-old female was admitted to the hospital after suffering from a cough for one month. At the time of admission, a contrast-enhanced chest CT revealed multiple nodules and plaques in her right lung, as well as the formation of cavities. The blood routine assays showed evidently increased white blood cell count (mainly neutrophils), CRP, and ESR, which suggested she was in the infection phase. The serum CrAg-LFA test showed a positive result. Initially, she was diagnosed with an unexplained pulmonary infection. Bronchoalveolar lavage fluid (BALF) samples were collected for microbial culture, immunological tests and the mNGS. Microbial culture and immunological tests were all negative, while mNGS detected Corynebacterium striatum, Pseudomonas aeruginosa, Streptococcus pneumoniae, and Cryptococcus neoformans. The diagnosis was revised to PC and bacterial pneumonia. Lung infection lesions were healed after she received targeted anti-infection therapy with mezlocillin and fluconazole. In a follow-up after 2 months, the patient's symptoms vanished. CONCLUSIONS Here, we demonstrated that mNGS was capable of accurately distinguishing Cryptococcus from M. tuberculosis in pulmonary infection, and notably mNGS was capable of swiftly and precisely detecting pathogens in mixed bacterial and fungal pulmonary infection. Furthermore, the results of mNGS also have the potential to adjust anti-infective therapies.
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Affiliation(s)
- Ziqian Qin
- Clinical Genome Center, Guangxi Kingmed Diagnostics, Nanning, 530007 Guangxi China
| | - Yiwu Zou
- grid.256607.00000 0004 1798 2653The First People’s Hospital of Qinzhou, The Tenth Affiliated Hospital of Guangxi Medical University, Qinzhou, 535000 Guangxi China
| | - Zehe Huang
- grid.256607.00000 0004 1798 2653The First People’s Hospital of Qinzhou, The Tenth Affiliated Hospital of Guangxi Medical University, Qinzhou, 535000 Guangxi China
| | - Ning Yu
- Clinical Genome Center, Guangxi Kingmed Diagnostics, Nanning, 530007 Guangxi China
| | - Zhenfeng Deng
- Clinical Genome Center, Guangxi Kingmed Diagnostics, Nanning, 530007 Guangxi China
| | - Zhencheng Chen
- grid.440723.60000 0001 0807 124XGuilin University of Electronic Technology, Guilin, 541004 Guangxi China
| | - Yuanli Wang
- grid.256607.00000 0004 1798 2653The First People’s Hospital of Qinzhou, The Tenth Affiliated Hospital of Guangxi Medical University, Qinzhou, 535000 Guangxi China ,grid.440723.60000 0001 0807 124XGuilin University of Electronic Technology, Guilin, 541004 Guangxi China
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Xiong C, Lu J, Chen T, Xu R. Comparison of the clinical manifestations and chest CT findings of pulmonary cryptococcosis in immunocompetent and immunocompromised patients: a systematic review and meta-analysis. BMC Pulm Med 2022; 22:415. [PMID: 36369001 PMCID: PMC9652893 DOI: 10.1186/s12890-022-02175-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 09/26/2022] [Indexed: 11/12/2022] Open
Abstract
Objective The purpose of our study was to perform a meta-analysis and systematic review to compare differences in clinical manifestations and chest computed tomography (CT) findings between immunocompetent and immunocompromised pulmonary cryptococcosis (PC) patients. Methods An extensive search for relevant studies was performed using the PubMed, EMBASE, Cochrane Library, and Web of Sciences databases from inception to September 30, 2021. We included studies that compared the clinical manifestations and chest CT findings between immunocompetent and immunocompromised PC patients. Study bias and quality assessment were performed using the Newcastle–Ottawa Scale (NOS). Results Nine studies involving 248 immunocompromised and 276 immunocompetent PC patients were included in our analysis. The NOS score of each eligible study was above 5, indicating moderate bias. The proportion of elderly patients (> = 60 years old) in the immunosuppressed group was significantly higher than that in the immunocompetent group (OR = 2.90, 95% CI (1.31–6.43), Z = 2.63, p = 0.01). Fever (OR = 7.10, 95% CI (3.84–13.12), Z = 6.25, p < 0.000) and headache (OR = 6.92, 95% CI (2.95–16.26), Z = 4.44, p < 0.000) were more common in immunosuppressed patients. According to thin-section CT findings, lesions were more frequently distributed in the upper lobe (OR = 1.90, 95% CI (1.07–3.37), Z = 2.2, p = 0.028) in immunocompromised individuals. The proportions of patients with cavity sign (OR = 5.11, 95% CI (2.96–8.83), Z = 5.86, p = 0.00), ground-glass attenuation (OR = 5.27, 95% CI (1.60–17.35), Z = 2.73, p = 0.01), and mediastinal lymph node enlargement (OR = 2.41, 95% CI (1.12–5.20), Z = 2.24, p = 0.03) were significantly higher in immunocompromised patients. Conclusion No significant differences in nonspecific respiratory symptoms were found between immunocompromised and immunocompetent PC patients. Nevertheless, fever and headache were more common in immunocompromised patients. Among the CT findings, cavity, ground-glass attenuation, and mediastinal lymph node enlargement were more common in immunocompromised individuals. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-02175-9.
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Zhang X, Hu Y, Tian C, Wei Q, Bian Y. Disseminated cryptococcosis mimicking malignant lymphoma on 18F-FDG PET/CT: A case report. Medicine (Baltimore) 2022; 101:e31374. [PMID: 36316948 PMCID: PMC9622613 DOI: 10.1097/md.0000000000031374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
RATIONALE Disseminated cryptococcosis is extremely rare and is easily misdiagnosed as a malignant lymphoma. 18F-Fluorodeoxyglucose Positron Emission Tomography (PET)/ computed tomography (CT) may be useful to assess the involvement of disseminated cryptococcosis and to evaluate residual disease after treatment. PATIENT CONCERNS A 21-years-old man presented with fever and cough for a month, with multiple red nodules scattered on the skin. 18F- Fluorodeoxyglucose PET/CT revealed multiple hypermetabolic lymph nodes in the upper and lower parts of the diaphragmatic region and hypermetabolic nodules in the skin. According to the PET/CT results, malignant lymphoma was considered a possibility, especially T-cell lymphoma involving the skin. DIAGNOSIS Cryptococcosis was diagnosed using inguinal lymph node biopsy and blood culture. INTERVENTIONS The patient received two months of amphotericin B, fluconazole, and half a month of meropenem. OUTCOMES The patient's body temperature returned to normal and the red nodules on the skin disappeared. Most of the hypermetabolic enlarged lymph nodes disappeared, which was confirmed by reexamination with PET/CT. LESSONS Disseminated cryptococcosis is easily misdiagnosed as malignant lymphoma, especially when the lymph nodes are more involved. When multiple hypermetabolic enlarged lymph nodes appear on PET/CT, except for lymphoma, specific infections should also be considered.
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Affiliation(s)
- Xinchao Zhang
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Yujing Hu
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Congna Tian
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Qiang Wei
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
| | - Yanzhu Bian
- Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China
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COVID-19 Associated with Cryptococcosis: A New Challenge during the Pandemic. J Fungi (Basel) 2022; 8:jof8101111. [PMID: 36294675 PMCID: PMC9604822 DOI: 10.3390/jof8101111] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a great threat to global health. In addition to SARS-CoV-2 itself, clinicians should be alert to the possible occurrence of co-infection or secondary infection among patients with COVID-19. The possible co-pathogens include bacteria, viruses, and fungi, but COVID-19-associated cryptococcosis is rarely reported. This review provided updated and comprehensive information about this rare clinical entity of COVID-19-associated cryptococcosis. Through an updated literature search till 23 August 2022, we identified a total of 18 culture-confirmed case reports with detailed information. Half (n = 9) of them were elderly. Fifteen (83.3%) of them had severe COVID-19 and ever received systemic corticosteroid. Disseminated infection with cryptococcemia was the most common type of cryptococcosis, followed by pulmonary and meningitis. Except one case of C. laurentii, all other cases are by C. neoformans. Liposomal amphotericin B and fluconazole were the most commonly used antifungal agents. The overall mortality was 61.1% (11/18) and four of them did not receive antifungal agents before death. Improving the poor outcome requires a physician's high suspicion, early diagnosis, and prompt treatment.
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Carpouron JE, de Hoog S, Gentekaki E, Hyde KD. Emerging Animal-Associated Fungal Diseases. J Fungi (Basel) 2022; 8:611. [PMID: 35736094 PMCID: PMC9225262 DOI: 10.3390/jof8060611] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 11/23/2022] Open
Abstract
The Global Action Fund for Fungal Infections (GAFFI) estimates that fungal diseases kill around 150 people each hour, and yet they are globally overlooked and neglected. Histoplasma and Talaromyces, which are associated with wildlife, cause systemic infections that are often lethal in patients with impaired cellular immunity. Dermatophytes that cause outbreaks in human hosts are often associated with domesticated animals. Changes in human behavior have been identified as a main cause of the emergence of animal-associated fungal diseases in humans, sometimes caused by the disturbance of natural habitats. An understanding of ecology and the transmission modes of causative agents is therefore essential. Here, we focus on fungal diseases contracted from wildlife and domesticated animals, their habitats, feces and carcasses. We discuss some basic fungal lifestyles and the risk of transmission to humans and illustrate these with examples from emerging and established diseases.
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Affiliation(s)
- Julia Eva Carpouron
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai 57100, Thailand; (J.E.C.); (E.G.)
- School of Science, Mae Fah Luang University, Chiang Rai 57100, Thailand
| | - Sybren de Hoog
- Centre of Expertise in Mycology, Radboud University Medical Centre/Canisius Wilhelmina Hospital, 6525 GA Nijmegen, The Netherlands;
| | - Eleni Gentekaki
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai 57100, Thailand; (J.E.C.); (E.G.)
- School of Science, Mae Fah Luang University, Chiang Rai 57100, Thailand
| | - Kevin David Hyde
- Center of Excellence in Fungal Research, Mae Fah Luang University, Chiang Rai 57100, Thailand; (J.E.C.); (E.G.)
- Institute of Plant Health, Zhongkai University of Agriculture and Engineering, Haizhu District, Guangzhou 510225, China
- Mushroom Research Foundation, 128 M.3 Ban Pa Deng T. Pa Pae, A. Mae Taeng, Chiang Mai 50150, Thailand
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Xin Z, Li B, Xue W, Lin W, Zhao Q, Zhang X. Pulmonary cryptococcosis mimicking lung cancer: 3 case report. Int J Surg Case Rep 2022; 94:106973. [PMID: 35658271 PMCID: PMC9093010 DOI: 10.1016/j.ijscr.2022.106973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Zhifei Xin
- Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Bowen Li
- Hebei General Hospital, Shijiazhuang, Hebei, China; North China University of Science and Technology, Tangshan, Hebei, China
| | - Wenfei Xue
- Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Wei Lin
- Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Qingtao Zhao
- Hebei General Hospital, Shijiazhuang, Hebei, China
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Tay E, Chen SCA, Green W, Lopez R, Halliday CL. Development of a Real-Time PCR Assay to Identify and Distinguish between Cryptococcus neoformans and Cryptococcus gattii Species Complexes. J Fungi (Basel) 2022; 8:jof8050462. [PMID: 35628719 PMCID: PMC9144077 DOI: 10.3390/jof8050462] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
Cryptococcus neoformans and Cryptococcus gattii are the principle causative agents of cryptococcosis. Differences in epidemiological and clinical features, and also treatment, mean it is important for diagnostic laboratories to distinguish between the two species. Molecular methods are potentially more rapid than culture and cryptococcal antigen (CRAG) detection; however, commercial PCR-based assays that target Cryptococcus do not distinguish between species. Here, we developed a real-time PCR assay targeting the multicopy mitochondrial cytochrome b (cyt b) gene to detect C. neoformans and C. gattii in clinical specimens. Assay performance was compared with culture, histopathology, CRAG and panfungal PCR/DNA sequencing. The cyt b-directed assay accurately detected and identified all eight C. neoformans/gattii genotypes. High-resolution melt curve analysis unambiguously discriminated between the two species. Overall, assay sensitivity (96.4%) compared favorably with panfungal PCR (76.9%) and culture (14.5%); assay specificity was 100%. Of 25 fresh frozen paraffin embedded (FFPE) specimens, assay sensitivity was 96% (76% for panfungal PCR; 68% for histopathology). The Cryptococcus-specific PCR is a rapid (~4 h) sensitive method to diagnose (or exclude) cryptococcosis and differentiate between the two major species. It is suitable for use on diverse clinical specimens and may be the preferred molecular method for FFPE specimens where clinical suspicion of cryptococcosis is high.
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Affiliation(s)
- Enoch Tay
- Research Education Network, Western Sydney Local Health District, Westmead Hospital, Westmead, NSW 2145, Australia;
| | - Sharon C-A. Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Westmead, NSW 2145, Australia; (S.C.-A.C.); (W.G.); (R.L.)
| | - Wendy Green
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Westmead, NSW 2145, Australia; (S.C.-A.C.); (W.G.); (R.L.)
| | - Ronald Lopez
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Westmead, NSW 2145, Australia; (S.C.-A.C.); (W.G.); (R.L.)
| | - Catriona L. Halliday
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, NSW Health Pathology, Westmead Hospital, Westmead, NSW 2145, Australia; (S.C.-A.C.); (W.G.); (R.L.)
- Correspondence: ; Tel.: +61-2-8890-6255
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