Cryptococcosis in HIV negative patients: findings on chest radiography

Abstract

BACKGROUND The findings at chest radiography in HIV negative patients with cryptococcosis are said to differ from those in HIV positive patients. No large series of HIV negative patients has been reported. METHODS A review of the medical charts and radiographs of 44 consecutive HIV negative patients with proven cryptococcosis was undertaken. RESULTS Air space consolidation involving one or more lobes was found in 15 patients (34%), one or more pulmonary masses in 13 patients (30%), and interstitial opacities in three patients (7%). No other radiographic finding was detected in more than one patient. Twelve of 23 patients (52%) with cryptococcal meningitis had abnormal chest radiographs, and 10 of 16 patients (62%) who presented with respiratory symptoms had air space consolidation. CONCLUSIONS HIV negative patients tend to have different radiographic findings from those reported in patients with AIDS. Cryptococcal meningitis in this group is usually associated with pulmonary mass(es) or a normal chest radiograph, whereas a respiratory presentation is usually associated with air space consolidation.