Membranous nephropathy with pulmonary cryptococcosis with improved 1-year follow-up results: A case report
Cryptococcosis is frequently found in immunosuppressed patients. It is also a significant opportunistic infection in non-immunocompromised individuals. In this study, we present a rare case of membranous nephropathy (MN) with pulmonary cryptococcosis. A 33-year-old man with MN was referred to our ho...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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De Gruyter
2021-02-01
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| Series: | Open Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1515/med-2021-0234 |
| _version_ | 1811252848529244160 |
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| author | Zhang Peipei Wang Chundan Zhang Jiudan Zhong Wenjing Xia Hong |
| author_facet | Zhang Peipei Wang Chundan Zhang Jiudan Zhong Wenjing Xia Hong |
| author_sort | Zhang Peipei |
| collection | DOAJ |
| description | Cryptococcosis is frequently found in immunosuppressed patients. It is also a significant opportunistic infection in non-immunocompromised individuals. In this study, we present a rare case of membranous nephropathy (MN) with pulmonary cryptococcosis. A 33-year-old man with MN was referred to our hospital because of dyspnea and weakness for 1 week. Before the above symptoms occurred, the dose of Cyclosporin A was increased again for relapse of MN. Multiple massive or patchy high-density shadows were present on computed tomography of the lung. Initially the patient underwent empirical anti-bacterial therapy, which turned out to be ineffective. As the results of serum cryptococcal latex agglutination tests were positive, the administration of anti-fungal drugs was prescribed. The results of fungal culture and pathologic examination of the lung tissue revealed the findings consistent with Cryptococcus neoformans. The patient was successfully treated with voriconazole followed by fluconazole with satisfactory result. Therefore, in patients with chronic kidney disease, lung lesions with poor bactericidal effects of cephalosporins need further examination to make sure whether there is pulmonary cryptococcosis. Early diagnosis and treatment might contribute to good results. It is a problem worthy of consideration that whether immunosuppressive agents need to be discontinued or not during antifungal therapy. |
| first_indexed | 2024-04-12T16:40:52Z |
| format | Article |
| id | doaj.art-eb4f22a52fa44eeea19d9afa2e805540 |
| institution | Directory Open Access Journal |
| issn | 2391-5463 |
| language | English |
| last_indexed | 2024-04-12T16:40:52Z |
| publishDate | 2021-02-01 |
| publisher | De Gruyter |
| record_format | Article |
| series | Open Medicine |
| spelling | doaj.art-eb4f22a52fa44eeea19d9afa2e8055402022-12-22T03:24:48ZengDe GruyterOpen Medicine2391-54632021-02-0116131131510.1515/med-2021-0234Membranous nephropathy with pulmonary cryptococcosis with improved 1-year follow-up results: A case reportZhang Peipei0Wang Chundan1Zhang Jiudan2Zhong Wenjing3Xia Hong4Department of Nephrology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Pathology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Endocrinology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Medical Image, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, ChinaDepartment of Nephrology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, ChinaCryptococcosis is frequently found in immunosuppressed patients. It is also a significant opportunistic infection in non-immunocompromised individuals. In this study, we present a rare case of membranous nephropathy (MN) with pulmonary cryptococcosis. A 33-year-old man with MN was referred to our hospital because of dyspnea and weakness for 1 week. Before the above symptoms occurred, the dose of Cyclosporin A was increased again for relapse of MN. Multiple massive or patchy high-density shadows were present on computed tomography of the lung. Initially the patient underwent empirical anti-bacterial therapy, which turned out to be ineffective. As the results of serum cryptococcal latex agglutination tests were positive, the administration of anti-fungal drugs was prescribed. The results of fungal culture and pathologic examination of the lung tissue revealed the findings consistent with Cryptococcus neoformans. The patient was successfully treated with voriconazole followed by fluconazole with satisfactory result. Therefore, in patients with chronic kidney disease, lung lesions with poor bactericidal effects of cephalosporins need further examination to make sure whether there is pulmonary cryptococcosis. Early diagnosis and treatment might contribute to good results. It is a problem worthy of consideration that whether immunosuppressive agents need to be discontinued or not during antifungal therapy.https://doi.org/10.1515/med-2021-0234cryptococcus neoformansmembranous nephropathypulmonary cryptococcosisanti-fungal drugs |
| spellingShingle | Zhang Peipei Wang Chundan Zhang Jiudan Zhong Wenjing Xia Hong Membranous nephropathy with pulmonary cryptococcosis with improved 1-year follow-up results: A case report Open Medicine cryptococcus neoformans membranous nephropathy pulmonary cryptococcosis anti-fungal drugs |
| title | Membranous nephropathy with pulmonary cryptococcosis with improved 1-year follow-up results: A case report |
| title_full | Membranous nephropathy with pulmonary cryptococcosis with improved 1-year follow-up results: A case report |
| title_fullStr | Membranous nephropathy with pulmonary cryptococcosis with improved 1-year follow-up results: A case report |
| title_full_unstemmed | Membranous nephropathy with pulmonary cryptococcosis with improved 1-year follow-up results: A case report |
| title_short | Membranous nephropathy with pulmonary cryptococcosis with improved 1-year follow-up results: A case report |
| title_sort | membranous nephropathy with pulmonary cryptococcosis with improved 1 year follow up results a case report |
| topic | cryptococcus neoformans membranous nephropathy pulmonary cryptococcosis anti-fungal drugs |
| url | https://doi.org/10.1515/med-2021-0234 |
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