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May 20, 2026American Journal of Respiratory and Critical Care Medicine

B72-21 Cryptococcal Pneumonia in an Immunocompetent Adult Patient: A Case Marked by Diagnostic and Therapeutic Challenges

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Authors

ISI SamreenRSR Subramanian

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Overview

Case presentation reveals diagnostic challenges and treatment strategies for cryptococcal pneumonia in an immunocompetent adult patient, suggesting implications for clinical practice.

Key Points

  • This case explores an unusual instance of cryptococcal pneumonia in an immunocompetent individual, examining diagnostic and therapeutic hurdles.
  • Reported on a 58-year-old man with type 2 diabetes presenting with pneumonia symptoms.
  • Conducted extensive infectious workups and repeated sCrAg testing alongside diagnostic imaging.
  • Initiated antifungal therapy with amphotericin B and transitioned to high-dose fluconazole after nephrotoxicity.
  • Initial sCrAg was positive but misattributed; repeated testing showed a markedly elevated titer of 1:2048.
  • Amphotericin B was discontinued after 7 days due to nephrotoxicity, followed by successful treatment with fluconazole.
  • Subsequent reductions in sCrAg titer to 1:512 and radiologic improvement were observed.

Cite This Study

Samreen et al. (2026) studied this question.

synapsesocial.com/papers/6a0d4f34f03e14405aa9a604https://doi.org/10.1093/ajrccm/aamag162.4310
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