Endobronchial pulmonary cryptococcosis and tuberculosis in an immunocompetent host

Thomas R, Christopher DJ, Balamugesh T, James P, Thomas M
Correspondence: Dr DJ Christoper, djchris@cmcvellore.ac.in

ABSTRACT
Pulmonary cryptococcosis presenting as an endobronchial tumour-like growth has rarely been described. We report the case of a male patient with normal immune function who presented with a right upper lobe mass lesion. Bronchoscopy revealed a tumour-like growth that completely occluded the anterior segment of the right upper lobe bronchus. Bronchial biopsy and computed tomography-guided lung biopsy revealed Cryptococcus, and culture of lung biopsy specimen grew Cryptococcus neoformans and Mycobacterium tuberculosis. The patient responded clinically to amphotericin B, fluconazole and anti-tuberculous therapy. However, chest radiographic response was unremarkable. A presentation of pulmonary cryptococcosis and tuberculosis, along with endobronchial tumour-like growth in the same patient, is unusual and has not been previously described.

Keywords:  cryptococcosis, endobronchial mass, tuberculosi
Singapore Med J 2012; 53(2): e32–e34