A Case of Disseminated Cryptococcal Infection and Concurrent Lung Tuberculosis in a Patient under Steroid Therapy for Interstitial Pneumonia

Table 1

Reported cases of concurrent cryptococcosis and tuberculosis in patients without HIV infection.

	Age/sex	Race	Region	Underlying disease	Pathological lesions (Cryptococcus/tuberculosis)	Treatment (Cryptococcus/tuberculosis)	Outcome	References
1	61M	NA	United States	NA	CSF/lung	AMPH-B/INH, SM	Recovered	[2]
2	69M	Caucasian	United States	NA	Both were detected in the same nodule in the lung	KCZ/INH, RFP	NA	[3]
3	51M	NA	Spain	Chronic epididymitis	Both were detected in CSF at almost the same time	AMPH-B, 5-FC/EB, INH, RFP, PZA	NA	[4]
4	61F	Caucasian	NA	Waldenstrom’s macroglobulinemia	CSF, blood/cerebral tissue	NA/EB, INH, RFP, SM	Lost to follow-up	[5]
5	34F	Asian	Saudi Arabia	NA	L4-5 vertebral abscess/right axillary lymph node	FLCZ/EB, INH, RFP, PZA	Recovered	[6]
6	25F	Asian	Italy	NA	Both were detected in CSF from the same sample	FLCZ, L-AMB/EB, INH, RFP, PZA, SM	NA	[7]
7	62 (on average)	NA	Taiwan			AMPH-B, 5-FC/EB, INH, RFP, PZA	Two patients died due to either of the two primary infections	[8]
8	18F	Asian	Canada	NA	Mediastinal lymph nodes and CSF/right upper lung lobe	AMPH-B, 5-FC/EB, INH, RFP, PZA	Recovered	[9]
9	65M	Asian	NA	NA	Both were detected in a large endobronchial mass	AMPH-B, ITCZ/NA	Lost to follow-up	[10]
10	58F	Asian	Taiwan	NA	Left upper and right lower lung lobe/neck lymph node	FLCZ/NA	NA	[11]
11	45F	NA	Turkey	SLE	Both were detected in CSF at almost the same time	AMPH-B, FLCZ, L-AMB/EB, INH, RFP, PZA	Discharged with neurological impairment	[12]
12	65F	Asian	Japan	Diabetes	CSF/left upper lung lobe	AMPH-B, FLCZ/EB, INH, RFP, PZA	Died due to aspiration pneumonia	[13]
13	56M	Asian	Japan	Diabetes, liver cirrhosis	Lung/lung (multiple nodules)	NA/INH, RFP, PZA, LVFX	Died due to hepatocellular carcinoma	[13]
14	83F	Asian	Japan	Rheumatoid arthritis, diabetes	Lung (revealed in autopsy)/lung, CSF, urine, and stool	No treatment/EB, INH, RFP, PZA	Died due to respiratory and heart failure	[13]
15	64M	Asian	Japan	Interstitial pneumonia	Skin, CSF, lungs, pleural membranes, prostate gland/right lower lung lobe, and right pleural effusion	FLCZ, 5-FC, L-AMB, VRCZ/INH, LVFX, AMK	Died due to respiratory failure	Present case

NA: not available, SLE: systemic lupus erythematosus, CSF: cerebrospinal fluid, L4-5: the 4th and 5th lumbar vertebrae, AMPH-B: amphotericin B, INH: isoniazid, SM: streptomycin, KCZ: ketoconazole, RFP: rifampicin, 5-FC: 5-fluorocytosine, EB: ethambutol, FLCZ: fluconazole, L-AMB: liposomal amphotericin B, PZA: pyrazinamide, ITCZ: itraconazole, VRCZ: voriconazole, LVFX: levofloxacin, and AMK: amikacin.
The article describes a study involving 12 non-HIV patients with coinfection of Cryptococcus and tuberculosis. Among the 12 patients, six had underlying diseases such as diabetes and eight had concurrent infections of the two pathogens in lungs, CSF, and other organs.